导管接触性溶栓治疗在肝移植术后早期肝动脉血栓形成中的应用  

Application of catheter-directed thrombolysis in early hepatic artery thrombosis after liver transplantation

作　　者：战激光[1] 姜璐[1] ZHAN Jiguang;JIANG Lu(Department of General Surgery,No.970 Hospital of the PLA Joint Logistic Support Force,Shandong,Yantai 264000,China)

机构地区：[1]中国人民解放军联勤保障部队第九七○医院普通外科,山东烟台264000

出　　处：《临床外科杂志》2021年第7期666-668,共3页Journal of Clinical Surgery

摘　　要：目的探讨肝移植术后早期肝动脉血栓形成(EHAT)的导管接触性溶栓(CDT)治疗的有效性和安全性.方法2009年1月~2019年11月接受CDT治疗的肝移植术后EHAT病人23例.结果本组均接受CDT治疗,放置CDT导管手术操作平均时间(78±24)分钟,溶栓治疗平均时间(87.4±22.8)小时,尿激酶平均用量(344.5±62.3)万U,经CDT治疗,19例肝动脉内血栓完全溶解,CDT治疗有效率为82.6%(19/23).溶栓过程中,腹腔轻微出血(<100 ml)2例,无其他相关并发症发生.平均随访时间(60.4±3.7)个月,19例肝动脉血栓完全溶解病人术后1年、2年、5年肝动脉通畅率分别为94.7%(18/19)、89.5%(17/19)、79%(15/19).结论CDT是一种安全、有效、微创的治疗方式,在肝移植术后EHAT病人的治疗及预后过程中发挥了重要作用.Objective To explore the efficacy and safety of catheter-directed thrombolysis(CDT)for early hepatic artery thrombosis(EHAT)after liver transplantation.Methods A retrospective analysis of the clinical data of 23 patients with EHAT after liver transplantation in our department from January 2009 to November 2019.Results All patients received CDT treatment.The average operation time of CDT catheter operation was(78±24)min.The average time of thrombolytic therapy was(87.4±22.8)h.The average dosage of urokinase was(344.5±62.3)million U.After CDT treatment,19 cases of hepatic artery thrombosis were completely dissolved,and the effective rate of CDT treatment was 82.6%(19/23).During CDT treatment,2 cases of abdominal hemorrhage(<100ml)occurred in 2 cases,and no other related complications occurred.The average follow-up time(60.4±3.7)months.The hepatic arterial patency rates of 19 patients with hepatic artery thrombosis completely dissolved at 1 year,2 years and 5 years were 94.7%(18/19),89.5%(17/19),79%(15/19).Conclusion CDT is a safe,effective,and minimally invasive treatment.It plays an increasingly important role in the treatment and prognosis of patients with EHAT after liver transplantation.

关 键 词：导管接触性溶栓 肝移植术后 早期肝动脉血栓形成 

分 类 号：R657.3[医药卫生—外科学]