血管性介入在肝脏移植中的应用

目的探讨血管性介入技术在肝脏移植前后诊治中的应用。方法对2003年1月~2005年2月对拟行肝脏移植的30例患者术前行肝动脉、肠系膜上动脉选择造影及经肠系膜上动脉间接门静脉造影;并对6例肝脏移植术后怀疑血管并发症的患者行造影及介入下溶栓及内支架治疗。结果30例患者术前造影中提示肝癌11例;4例患者动脉造影显示动脉血管变异。29例患者间接门脉造影成功,其中2例肝癌患者发现门脉癌栓,26例存在不同程度的静脉曲张。对6例怀疑胆道和血管并发症的患者作血管造影及相关介入治疗。其中2例成功行狭窄动脉吻合口金属内支架治疗,1例行动脉溶栓治疗,造影显示肝动脉血流恢复通畅;其他3例介入治疗效果不满意。结论血管造影能够提供准确的动脉和门静脉解剖和变异信息;血管介入技术有助于对肝移植术后早期血管并发症诊断和处理。

The application of vascular interventional radiology on liver transplantation

Objective To evaluate the application of vascular interventional technique on the diagnosis and treatment of liver transplantation patients. Methods Selective angiography of hepatic artery and indirect portal vein angiography through superior mesenteric artery (SMA)was done in 30 patients before liver transplantation. Six patients with suspected vascular complications underwent angiography and thromblytic interventional therapy. Results All 30 patients had pre-transplantation angiography, revealing 11 patients with hepatic carcinoma and 4 with arterial variation. Twenty-nine patients had successful indirect portal vein angiography, showing 2 patients with carcinoma emboli in the portal veins and 26 with different varicosis. Six patients with suspected vascular and biliary complications were treated successfully with intervention including 2 with stent placement in the stenotic artery one, with thrombolysis and another 3 unsuccessful cases.Conclusions Angiography can provide precise anatomic and varied information about arteries and portal vein.Vascular intervention technique is helpful to the diagnosis and treatment of early vascular complications after hepatic transplantation.