肝移植术后急性肝动脉血栓形成的介入治疗  

Interventional therapy for acute hepatic artery thrombosis after liver transplantation

作　　者：张华[1,2] 王建华[1,2] 颜志平[1] 程洁敏[1] 刘嵘[1] 钱晟[1] 周俭[3] 

机构地区：[1]复旦大学附属中山医院介入放射科,上海200032 [2]上海市影像医学研究所,上海200032 [3]复旦大学附属中山医院肝外科,上海200032

出　　处：《复旦学报（医学版）》2017年第2期181-185,212,共6页Fudan University Journal of Medical Sciences

摘　　要：目的评估介入治疗急性肝动脉血栓形成的近期与远期疗效。方法对复旦大学附属中山医院2003年3月至2015年10月出现的34例急性肝动脉血栓形成患者的介入处理方式和长期随访资料进行回顾性分析。结果 34例急性肝动脉血栓形成患者均行经肝动脉置管尿激酶溶栓治疗。其中21例溶栓过程中联合支架植入,3例合并脾动脉盗血行脾动脉栓塞。技术和临床成功率均为91%(31/34)。2例出现与介入操作相关的并发症。肝动脉1年、2年、3年及5年通畅率分别为82%、73%、57%和57%。患者的无阻塞中位生存期达94个月。结论介入治疗急性肝动脉血栓形成获得了良好的近期与远期疗效,可作为肝移植术后急性肝动脉血栓形成的首选治疗方式。Objective To evaluate the short-term and long-term efficacy of interventional therapy for acute hepatic artery thrombosis. Methods We analyzed retrospectively the interventional treatment and long-term follow-up data of 34 patients with acute hepatic artery thrombosis in Zhongshan hospital of Fudan University from March 2003 to October 2015. Results Thirty-four patients with acute hepatic artery thrombosis were performed with urokinase thrombolytic therapy. Twenty-one patients were implanted stents in the thrombolytic therapy. Splenic artery embolization were performed in 3 patients with splenic artery steal syndrome. Technical and clinical success rates were 91% （31/34）. The complication associated with interventional procedures were observed in 2 patients. The patency rates of hepatic artery in 1, 2, 3 and 5 years were 82%, 73%, 57% and 57%, respectively. The median obstruction free time was 94 months. Conclusions Good short-term and long-term effect have been obtained in interventional treatment for acute hepatic artery thrombosis, which can be used as the first treatment for acute hepatic artery thrombosis after liver transplantation.

关 键 词：肝移植 急性肝动脉血栓形成 介入治疗 

分 类 号：R657.3[医药卫生—外科学]