彩色多普勒超声在小儿部分肝移植血管并发症中的应用

目的：正确评价彩色多普勒超声成像(CDFI)技术在围手术期小儿部分肝移植血流动力学监测中价值，寻找可靠的方法及早发现肝移植血管并发症。方法：应用彩色多普勒及频谱多普勒技术对5例小儿部分肝移植病例的受体及供体进行术前评价，术中指导及术后监测，参照国外文献标准，重点观察受体术后肝血流动力学各参数包括肝脏动、静脉及门静脉血流频谱形态变化，及时发现血管狭窄及血栓等严重并发症。结果：5例小儿部分肝移植病例，手术顺利，术后CDFI即时发现门静脉血栓1例，肝静脉狭窄1例，经过再次手术取栓及狭窄处球囊扩张后，两例血流灌注恢复正常，未发现肝动脉狭窄及血栓。结论：应用CDFI监测各项血流指标，可以确定活体肝移植手术适应症，术中指导手术方式并实时观察血管吻合情况和血流灌注情况，术后及早发现多种并发症，尤其是肝脏血管狭窄及血栓形成等严重并发症，具有较高的敏感性和特意性，提高了手术的成功率和生存率，成为肝移植手术非常关键的检查方法之一。

Use of Color Doppler Sonography for Revealing Vascular Complications in Pediatric Splitting Liver Transplantation

Objective:The purpose of this study was to determine the utility of color Doppler flow image(CDFI) for the diagnosis and reduction of vascular complications in pediatric splitting liver transplantation Methods:Five patients received splitting liver transplantation The hemodynamics and waveforms of hepatic vein ,portal vein and hepatic artery were evaluated by CDFI during 180 days of post operation in order to find vascular complications,hepatic artery thrombosis(HAT) or hepatic artery stenosis (HAS) Results:The hemodynamics and waveforms of hepatic artery during and after surgery were normal HAT or hepatic artery stenosis (HAS)were not found One patient had portal vein thrombosis and one had hepatic vein stenosis after liver transplantation These abnormalities were all first found by CDFI and successfully reconstructed by surgical or interventional procedures The survival rate reached to 100% Conclusions:CDFI is efficient on early diagnosis of abnormal hepatic vascular complications after liver transplantation and can enhance a better survival rate for patients