彩色多普勒超声在肝移植术后发生肝动脉狭窄及其围介入治疗中监测价值

目的探讨彩色多普勒超声在肝移植术后发生肝动脉狭窄及其围介入治疗中的监测作用。方法回顾性分析71例原位肝移植病人的超声检查资料,其中发生肝动脉狭窄并进行介入治疗的5例,并与同期血管造影对照。结果发生肝动脉狭窄病人彩色多普勒血流显像(CDFI)可见肝动脉纤细迂曲,多呈间断性星点闪烁状;近狭窄处肝动脉血流峰速(S1)升高(163．62±14．66)cm／s,远端动脉血流峰速(S2)降低(19．10±3．91)cm／s;阻力指数(RI)降低(0．38±0．07);收缩期血流加速时间(SAT)延长(98．00±9．41)ms;行经皮血管成形术,当狭窄部分、全部解除时,肝动脉各段血流峰速均相应不同程度向正常恢复,S1为(73．68±8．81)cm／s;S2为(37．18±4．80)cm／s,而阻力指数仍长时间维持降低(0．42±0．06),SAT长时间维持延长(98．20±6．80)ms。结论彩色多普勒超声在肝移植术后发生肝动脉狭窄及其围介入治疗中具有较高监测价值。

Hemodynamic monitoring of postoperative hepatic artery stenosis and interventional treatment in liver transplantation with color Doppler ultrasonography

Objective To determine the value of color Doppler ultrasonography for hemodynamic monitoring of postoperative hepatic artery stenosis and interventional treatment in liver transplantation. Methods The Doppler flow data of 5 cases of hepatic artery stenosis and interventional treatment were summarized and contrasted with the results of angiography by reviewing the Doppler flow data of 71 cases of orthotopic liver transplantation. Results The liver artery became thinner, discontinuous, roundabout and looked like shining stars in the color Doppler images of the patients with hepatic artery stenosis. The peak systolic velocity was increased near the narrowing of the liver artery (163.62(?)14.66 cm/s). The resistance index was decreased (0.38(?)0.07) and the systolic artery acceleration time was delayed (98.00(?)9.41 ms). After percutaneous transluminal angioplasty angioplasty, the peak systolic velocity tended to return to the normal level uncoordinatedly (73.68(?)8.81 cm/s), when the stenosis was partly or completely released. However, the resistance index kept decreasing (0.42(?)0.06) and the systolic artery acceleration time kept prolonging (98.20(?)6.80 ms) for a long time. Conclusions Color Doppler ultrasonography has important value for hemodynamic monitoring of postoperative hepatic artery stenosis and interventional treatment in liver transplantation.