肝移植术后下肢深静脉血栓的超声检测与危险因素分析

目的 探讨肝移植术后下肢深静脉血栓(deep vein thrombosis,DVT)的超声影像特征和DVT形成的危险因素.方法 选取深圳市第三人民医院行肝移植手术患者141例,术前均采用超声检查下肢静脉,记录有无DVT,术后1、7、14 d复查DVT发生情况.分析性别、年龄、高血压、糖尿病、肿瘤史、长期饮酒史、 胆固...

Ultrasound detection and risk factor analysis of lower extremity deep vein thrombosis after liver transplantation

Objective To investigate the ultrasound imaging characteristics and risk factors of lower extremity deep vein thrombosis(DVT)formation after liver transplantation.Methods A total of 141 patients who underwent liver transplantation in our hospital were selected,all of them received lower extremity veins examination by ultrasonography before operation,and the presence or absence of DVT was recorded.The occurrence of DVT at 1,7,and 14 d after operation was monitored.The sex,age,hypertension,diabetes mellitus,tumor history,history of long-term alcohol consumption,cholesterol concentration,triglyceride concentration,HDL concentration,LDL concentration,D-dimer concentration,history of lower extremity deep venipuncture tube placement,total operation time,duration of anhepatic phase,intraoperative blood loss and blood transfusion,MELD score were analyzed.Results DVT was not detected before transplantation;DVT was detected in 33 cases after operation,and the overall incidence of DVT was 23.4%.All occurred within 7 d after operation.Univariate regression analysis showed that there were significant differences in total cholesterol concentration,high density lipoprotein concentration,D-dimer concentration,intraoperative bleeding and blood transfusion,MELD score,tumor history and lower extremity deep vein puncture and catheterization between patients wito or without DVT(P<0.05).Logistic multivariate regression analysis showed that the history of lower extremity deep vein puncture,high MELD score and high D-dimer concentration were the risk factors of DVT after liver transplantation(P<0.05).Conclusion Ultrasound can clearly diagnose the formation of lower limb DVT after liver transplantation.Total cholesterol concentration,high density lipoprotein concentration,D-dimer concentration,intraoperative bleeding and blood transfusion,MELD score,tumor history and lower limb deep vein puncture and catheterization history are important factors for the formation of DVT.Ultrasound monitoring should be focused on patients with the above high-risk factors.