彩色多普勒超声研究肝移植后门静脉血流动力学变化

目的探讨肝移植术后的门静脉血流动力学变化规律。方法应用灰阶和彩色多普勒超声检测了15例正常人和22例原位肝移植患者术后的肝脏。总结14例无明显并发症原位肝移植患者的门静脉时间平均血流速度（TAV）变化规律和5例肝动脉血栓形成患者及3例门静脉并发症患者的门静脉血流动力学变化。结果①肝移植术后无并发症的患者早期门静脉TAV显著高于对照组，但呈下降趋势，至手术3个月后与对照组差异无显著性意义。②5例肝动脉血栓形成患者的门静脉TAV高于肝移植后同期无并发症的患者。③3例门静脉并发症患者的门静脉血流紊乱。结论肝移植后门静脉TAV逐渐下降，至手术3个月后恢复正常；门静脉血流动力学变化对肝移植后并发症的协助诊断有重要意义。

Study on portal venous dynamics after orthotopic liver transplantation with color Doppler ultrasound

Objective To investigate the pattern of portal venous dynamics following orthotopic liver transplantation (OLT) with color Doppler ultrasonography(CDUS). Methods Sonograms and the sonographic reports from 22 patients who had undergone liver transplantation were analyzed, with 15 normal persons as controls. Among the 22 patients, eight were accompanied with certain complications. The characteristics of portal venous changes after OLT with vascular complications were summarized, as well as those without complications. Results The portal vein time averaging velocity (TAV) in one month after OLT was markedly higher than that of control group(P< 0.01), then declined gradually. There were no significance between control and the OLT after 3 months (P> 0.05). The portal vein TAV in 5 patients with hepatic artery thrombosis, which all occurred in one month, was higher than that of the simultaneous 15 OLT patients without complications. Among three OLT patients with portal venous complications, one with portal venous thrombosis and the other two with portal venous stenosis, experienced irregular and disturbed portal vein flows. Conclusions Portal venous TAV after OLT recovered in 3 months. CDUS was of practical importance in diagnosis of vascular complications after OLT.