肝移植术后肝动脉并发症的介入诊断与治疗  

Interventiona1 diagnosis and treatment of hepatic artery complications after liver transplantation

作　　者：陈尘[1] 高健[1] 胡立宝 

机构地区：[1]北京大学人民医院放射科,100044

出　　处：《中国医药》2015年第10期1478-1480,共3页China Medicine

摘　　要：目的 评价介入技术在肝移植术后肝动脉并发症的诊断与治疗中的价值.方法 回顾性分析2005年5月至2015年4月北京大学人民医院8例肝移植术后肝动脉并发症患者介入诊断和治疗及随访资料.结果 肝动脉血栓形成6例,其中4例动脉溶栓后,发现伴肝动脉狭窄,2例重度狭窄者行肝动脉支架成形术,1例轻中度狭窄者仅予溶栓治疗,1例狭窄血管伴严重扭曲者溶栓治疗效果不佳,行开腹肝动脉切开取栓及吻合术;1例可见侧支循环建立,未予治疗;1例溶栓后血管通畅,未见狭窄.移植后脾动脉盗血综合征4例,行脾动脉栓塞术.肝动脉假性动脉瘤1例,行支架辅助动脉瘤栓塞术.随访1例肝动脉狭窄行动脉支架成形术患者术后5d因肝细胞广泛坏死行2次肝移植;余7例随访23 ～108个月肝功能均未见异常.结论 介入技术能有效地诊断和治疗肝移植术后肝动脉并发症.Objective To evaluate the value of intervention technique in diagnosing and treating hepatic artery complications after liver transplantation.Methods Data of 8 patients with hepatic artery complications after liver transplantation from May 2005 to April 2015 were retrospectively analyzed.Results Totally 6 patients had hepatic artery thrombosis;among them,hepatic artery stenosis was found after intra-arterial thrombolysis in 4 cases.Among them,2 cases had severe stenosis and underwent hepatic artery stent angioplasty;1 case had mild-moderate stenosis and underwent thrombolytic therapy;1 case had ineffective thrombolysis due to severe artery distortion and underwent hepatic artery embolectomy and anastomosis.The collateral circulation was established in 1 case and no treatment was given;no hepatic artery stenosis was found after intra-arterial thrombolysis in 1 case;1 patient had splenic artery steal syndrome and underwent splenic artery embolization;1 patient had hepatic artery pseudoaneurysm formation and underwent stent placement assisted aneurysm embolization.One case with hepatic artery stenosis who underwent hepatic artery stent angioplasty received repeated liver transplantation to extensive hepatocyte necrosis,and the liver functions were all normal in the other cases.Conclusion Intervention technique can diagnose and treat various hepatic artery complications after liver transplantation effectively.

关 键 词：肝移植 肝动脉并发症 介入 介入放射学 

分 类 号：R657.3[医药卫生—外科学]