彩色多普勒超声检查诊断肝移植术后胆道并发症价值分析*

目的 探讨采用彩色多普勒超声检查诊断肝移植术后胆道并发症的应用价值,为提高移植肝的存活率提供保障。方法 2014年5月~2018年9月在我院行肝移植术的54例患者,采用胆道造影和彩色多普勒超声检查胆道情况。结果 经胆道造影检查,发现14例发生了肝移植术后胆道并发症,其中胆道狭窄9例,胆管内胆泥或胆石形成5例;有并发症患者肝内胆管内径和总胆管内径分别为（4.7±2.1） mm和（7.5±3.6） mm,显著大于40例无并发症患者的（1.2±0.5） mm和（4.3±1.6） mm（P<0.05）,有并发症患者肝内胆管壁厚和总胆管壁厚分别为（2.3±0.4） mm和（4.7±1.5） mm,显著大于无并发症患者的（0.8±0.2） mm和（2.1±0.9） mm（P<0.05）;以总胆管内径>6 mm、胆管壁回声增强和总胆管壁厚度>3.5 mm作为诊断标准,彩色多普勒超声检查诊断肝移植术后胆道并发症的敏感度为57.1%,特异度为80.0%。结论 使用彩色多普勒超声检查诊断肝移植术后胆道并发症的发生具有无创、方便和可重复进行的优点,具有很大的临床应用价值。

Application of color Doppler ultrasonography in the diagnosis of biliary complications in patients after liver transplantation

Objective The aim of this study was to explore the value of color Doppler ultrasonography in the diagnosis of biliary complications in patients after liver transplantation,and to provide a guarantee for improving the survival rate of transplanted liver.Methods The clinical data of 54 patients underwent liver transplantation were analyzed in our hospital between May 2014 and September 2018. Color Doppler ultrasonography and cholangiography were carried out in all the patients.Results 14 patients were found to have biliary complications in our series of patients after liver transplantation,with biliary stricture in 9 and biliary sldge sediment and gallstone formation in 5;the diameters of the intrahepatic bile ducts and the common bile ducts in patients with biliary complications were （4.7±2.1） mm and （7.5±3.6） mm,both significantly larger than （1.2±0.5） mm and （4.3±1.6） mm in those without（P<0.05）;the wall thickness of the inner bile ducts and the common bile ducts were （2.3±0.4） mm and （4.7±1.5） mm,both significantly larger than （0.8±0.2） mm and （2.1±0.9） mm in those without（P<0.05）;we set the total bile duct diameter>6 mm,having bile duct wall echo enhancement and total bile duct wall thickness>3.5 mm as the diagnostic criteria,the sensitivity of color Doppler ultrasonography for diagnosing biliary complications after liver transplantation was 57.1%,and the specificity was 80.0%. Conclusion The application of color Doppler ultrasonography for the diagnosis of biliary complications after liver transplantation is noninvasive,convenient and repetitive,which might help the clinicians to make a comprehensive judgment and evaluation.