彩色多普勒超声在肝移植术后并发症诊断中的应用

目的探讨彩色多普勒超声在肝移植术后并发症中的诊断价值。方法146例肝移植患者,术后应用彩色多普勒超声常规检查移植肝、胆道、血管及胸腹腔情况,测量血流参数（收缩期峰值流速、阻力指数等）,胆管直径,并与其他影像学检查相对比。结果超声检查提示肝移植术后胆道并发症23例,包括胆漏1例,胆管狭窄22例,其中合并胆管结石17例,合并肝内胆淤积或肝脓肿10例;血管并发症7例,包括肝动脉血栓5例,肝动脉血栓合并门静脉血栓1例,下腔静脉血栓1例。另外,探及肝周血肿18例,以及肝癌移植术后复发7例。结论彩色多普勒超声为肝移植术后并发症的诊断提供了重要的依据,具有较高的临床应用价值。

Color Doppler Ultrasonography in Diagonsis of Complications After Orthotopic Liver Transplantation

Objective To evaluate the value of color Doppler ultrasonography on the diagnosis of complication after orthotopic liver transplantation(OLT).Methods A total of 146 patients were included in this study.The hepatic parenchyma,bile duct and hepatic blood flow were observed on ultrasonography.The maximum blood flow velocity,resistanced index and diameter of the bile duct were measured.The results were compared with other imaging.Results Among the 146 patients,biliary complications were the most common one(23/146),including biliary stricture(22/23),bile calculi(17/23),hepatic abscess(10/23),and bile leakage(1/23).Seven patients had vascular complications including hepatic artery thrombosis(HAT)in 5 cases,portal vein thrombosis combined with HAT in 1 and inferior vena cava thrombosis in 1.Ultrasonography showed intraheaptic carcinoma recurrence in 7 patients in the postoperative period.In 18 patients,hematomas near the liver was found on sonography.Conclusions Color Doppler ultrasonography is valuable for monitoring liver post-transplantation complications.