肝移植术后门静脉血栓并闭塞的介入治疗  

Percutaneous Interventional Treatment for Portal Vein Thrombosis Combined with Occlusion Following Liver Transplantation

作　　者：张升宁[1] 钟粤明[2] 赵永恒[1] 陈永林[1] 陈文忠[2] 李来邦[1] 刘静[1] 冉江华[1] 李立[1] 

机构地区：[1]昆明市第一人民医院暨昆明医科大学附属甘美医院肝胆胰外科云南省器官移植研究所肝移植研究中心,云南昆明650011 [2]昆明市第一人民医院介入科,云南昆明650011

出　　处：《中国普外基础与临床杂志》2015年第12期1439-1442,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的 探讨介入治疗肝移植术后门静脉血栓并闭塞的价值。方法 回顾性分析我中心2006年5月至2015年1月期间肝移植术后3例门静脉血栓导致门静脉闭塞并发症的介入治疗及其疗效。结果 3例患者术前发现门静脉轻微附壁血栓,Yerdel分级均为1级,移植术中未行血栓切除术,直接供/受体门静脉端-端吻合,术后8个月以后出现门静脉血栓并闭塞,均采用球囊扩张血管成形及自膨式支架植入治疗,介入治疗的技术成功率为100%。随访28--38个月,无并发症发生,移植物功能及患者生存情况均良好。结论 经皮血管内介入技术是治疗肝移植术后门静脉血栓并闭塞并发症的一种安全、有效的方法。Objective To evaluate value of percutaneous interventional treatment for portal vein thrombosis combined with occlusion following liver transplantation. Method The data of 3 patients with portal vein thrombosis combined with occlusion following liver transplantation underwent interventional treatment were analyzed retrospectively. Results The mural thrombi were detected preoperatively in the portal venous trunk for the 3 patients, all of which were classified as Yerdel＇s grade 1 and were underwent porto-portal anastomosis without thrombectomy during liver transplantation. Portal vein thrombosis combined with occlusion occured after 8 months postoperatively. The percutaneous transhepatic balloon venoplasty and self-expanding metallic stents placement was performed in 3 patients. The interventional treatment was successfully achieved in all the patients. The follow-up period ranged from 28 to 38 months, no complications occurred following interventional treatment, the graft function and survival of patients were good. Conclusion Percutaneous interventional treatment is an efficacious and safe method to treat portal vein thrombosis combined with occlusion.

关 键 词：肝移植 门静脉血栓 并发症 介入治疗 

分 类 号：R657.3[医药卫生—外科学]