肝移植术后动脉窃血综合征的介入诊疗(附5例报道)

目的:对肝移植术后动脉窃血综合征的诊断和介入治疗进行初步的探讨.方法:5例患者因肝移植治疗术后超声多普勒检查肝内未见动脉血流,提示肝动脉闭塞而行急症DSA检查.血管造影诊断为窃血综合征,并行窃血动脉介入栓塞治疗.结果:5例患者中脾动脉窃血4例,胃十二指肠动脉和胃右动脉窃血1例,患者随访时间3～9个月,随访期间患者移植肝脏功能正常,未见与动脉栓塞相关的并发症发生.结论:肝移植术后动脉窃血综合征虽然发生率不高,但造成的危害严重,应该受到重视,早期诊断、早期治疗彩夺目对于移植肝脏功能的保护相当重要.介入栓塞治疗以其微创、高效、并发症少的优点,应作为首选的治疗方法.

The Diagnosis and Interventional Radiology Treatment of Artery Steal Syndrome Following Liver Transplantation

Objective:To discuss the diagnosis and interventional radiology treatment of artery steal syndrome following liver transplantation.Methods:5 cases of the 687 liver transplantation patients were diagnosed "artery steal syndrome" by arteriography,for Doppler ultrasound revealed that the flow of hepatic artery was disappeared.All of 5 patients were treated by interventional embolization.Results:All patients had successes treatment.4 patients were splenic artery steal syndrome,1 patient was gastroduodenal artery and right gastric artery steal syndrome.Follow up ranged from 3 month to 9 month.The functions of transplant liver were normal and no complications of embolization were occurred in follow up.Conclusion:Artery steal syndrome following liver transplanation,a scarce complication of hepatic artery,it could cause severe graft injury,and should be diagnosed and treated early as soon as possible.Interventional embolization is one of the treatments available because of minimally invasive and immediate clinical improvement.