肝移植术后门静脉血流动力学变化的超声长期随访研究

目的 探讨肝移植术后门静脉血流动力学变化的长期转归规律.方法 应用彩色多普勒超声测量121例原位移植肝患者术后门静脉血流动力学变化,自术前直至术后4年进行长期定期随访.记录门静脉平均血流速度,脾脏厚度并与40例正常人对照.结果 (1) 肝移植患者术后1～3 d内门静脉血流速度显著增加,随时间延长呈下降趋势,至术后12个月与对照组无显著差异(P>0.01);(2)肝移植患者术后脾肿大逐渐缩小,但持续至术后4年,与对照组比较肿大仍有显著性差异(P<0.01).结论 肝移植患者术后门静脉平均血流速度可在较短时间与正常人群无差异,但是脾肿大的持续时间明显延长,提示内脏血流动力异常可能需要更长时间恢复.

Long-term Study of Hemodynamic Changes in Portal Venous Flow after Liver Transplantation with Ultrasound

Objective To evaluate the long-term changes of portal venous flow after liver transplantation with ultrasound.Methods The effect of liver transplantation on portal venous hemodynamics was recorded by color Doppler sonography in 121 patients who were followed for up to 4 years.Sonographic parameters such as portal blood flow mean velocity and spleen size were analyzed among 40 controls.Results (1) Portal blood velocity increased dramatically from 1 to 3 days after transplantation and then declined gradually.There was no significant difference between control and transplantation groups after 12 months(P>0.01);(2)Spleen size decreased gradually but still remained significantly bigger than that in the control group after 4 years(P<0.01).Conclusions Portal blood velocity was not different from normal subjects 12 months after transplantation,but splenomegaly lasted a long period,which probably indicated that normalization of splanchncic hemodynamics parameters required more time.