儿童亲体肝移植术后超声血流动力学特点及与生长发育因素的相关性:单中心大数据回顾  

Normal reference range of ultrasound blood flow parameters and correlation with growth after pediatric parental liver transplantation:a retrospective study using single center big data

作　　者：牛宁宁[1] 唐缨[1] 孔维娜 王明阳 张国英[1] 于慧敏[1] 刘菁[1] Niu Ningning;Tang Ying;Kong Weina;Wang Mingyang;Zhang Guoying;Yu Huimin;Liu Jing(Department of Ultrasound,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院超声科,天津300192

出　　处：《中华超声影像学杂志》2024年第6期505-511,共7页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(82172031);天津市科技计划项目(21JCYBJC01800);天津市卫生健康科技项目(TJWJ2023QN032)。

摘　　要：目的通过大数据查询统计分析获得儿童亲体肝移植术后血流动力学超声参数的正常参考值范围,并对比其随年龄增长的变化。方法应用天津市第一中心医院自主开发的临床肝移植超声影像大数据库软件V1.0查询2012年12月至2022年12月0~14岁儿童亲体肝移植术后患者在术后第1 d、第7 d、第1个月、第6个月、第1年、第5年、第10年的超声血流动力学参数,包括门静脉流速(PVV)、肝动脉峰值流速(S)、肝动脉舒张末期流速(D)、肝左静脉流速(LHVV)等,分析超声血流参数在不同年龄组随术后时间延长的变化,比较各年龄组间的差异,获得各参数的正常参考值范围。结果本研究共纳入儿童亲体肝移植术后患者731例,年龄0~14岁,共5283次监测结果。超声血流动力学参数PVV,肝动脉S、D,LHVV在术后7 d最高,之后随着术后时间的延长,逐步呈持续略减低趋势,部分参数略有波动;同时对各年龄组间比较,PVV,肝动脉S、D,LHVV差异无统计学意义(均P>0.05),并获得各年龄组PVV,肝动脉S、D,LHVV的正常参考值范围。结论本研究得到儿童亲体肝移植术后超声血流动力学参数随随访时间延长的走行趋势,同时对不同年龄组间进行比较,儿童肝移植术后随着年龄的增长,肝脏的血流动力学参数无明显改变,并获得各参数在不同年龄组的参考值范围,对及早发现及诊断术后血管并发症具有重要临床意义。儿童肝移植较成人更为复杂,在临床监测中,需更加重视移植肝血流的动态变化,结合患者个体状态,为临床诊断提供影像学支持。Objective To obtain the normal reference range of hemodynamic ultrasound parameters after pediatric liver transplantation through big data query and statistical analysis,and compare their changes with age.Methods The clinical liver transplantation ultrasound imaging database software V1.0 independently developed by Tianjin First Central Hospital was used to query the ultrasound hemodynamic parameters of 0-14 years old pediatric patients after parental liver transplantation from December 2012 to December 2022,including portal vein diameter(PVD)on the 1st day,7th day,1st month,6th month,1st year,5th year,and 10th year after surgery.The changes in ultrasound blood flow parameters such as portal vein velocity(PVV),hepatic artery peak velocity(S),hepatic artery end diastolic velocity(D),and left hepatic vein velocity(LHVV)with postoperative time in different age groups were analyzed,the differences between age groups were compared,and statistical analysis was perform to obtain the 95%reference value range for each parameter.Results A total of 731 pediatric patients aged 0-14 years who underwent parental liver transplantation were included in this study,with a total of 5283 monitoring results.The ultrasound hemodynamic parameters PVV,hepatic artery S,D,and LHVV were highest at 7th day after surgery,and gradually showed a sustained and slightly decreasing trend with the prolongation of postoperative time.At the same time,there was no statistically significant difference in PVV,hepatic artery S,D,and LHVV among different age groups(all P>0.05).Conclusions This study obtains the trend of ultrasound hemodynamic parameters after pediatric liver transplantation with prolonged follow-up time,and compared them among different age groups.After pediatric liver transplantation,there is no significant change in liver hemodynamic parameters with increasing age.Obtaining reference value ranges for various parameters in different age groups is of great clinical significance for early detection and diagnosis of postoperative vascular

关 键 词：超声检查 儿童 肝移植 血流动力学 参考值范围 

分 类 号：R726.5[医药卫生—儿科] R445.1[医药卫生—临床医学]