CAJ | 학술논문

目的评价肝移植术后门静脉狭窄的介入治疗的效果及安全性.方法回顾性分析2004年4月至2012年1月收治的肝移植术后门静脉狭窄患者30例,所有患者均具有门静脉高压的临床症状、体征或经超声检查等影像学检查显示门静脉狭窄.经皮肝穿刺门静脉造影明确门静脉狭窄的部位、范围和程度,球囊扩张后行支架植入.同时行胃冠状静脉造影,如严重曲张或者影响门静脉血流则行栓塞治疗.介入治疗后对患者进行随访,记录患者的临床症状、实验室检查结果及超声检查等影像学检查结果.结果 30例患者均成功接受门静脉造影,其中1例未能通过狭窄的门静脉主干；其余29例中,25例行球囊扩张后支架植入术,共植入26个自膨式支架；4例行球囊扩张治疗.介入治疗的技术成功率为96.7％(29/30).7例行曲张的胃冠状静脉弹簧圈栓塞.介入治疗相关的并发症为胸膜腔出血2例.随访期为1～72个月(平均21.5个月),所有接受介入治疗患者的门静脉均通畅,未出现支架内再狭窄.结论介入治疗肝移植术后门静脉狭窄安全、有效,门静脉通畅率良好.
목적 평개간이식술후문정맥협착적개입치료적효과급안전성.방법 회고성분석2004년4월지2012년1월수치적간이식술후문정맥협착환자30례,소유환자균구유문정맥고압적림상증상、체정혹경초성검사등영상학검사현시문정맥협착.경피간천자문정맥조영명학문정맥협착적부위、범위화정도,구낭확장후행지가식입.동시행위관상정맥조영,여엄중곡장혹자영향문정맥혈류칙행전새치료.개입치료후대환자진행수방,기록환자적림상증상、실험실검사결과급초성검사등영상학검사결과.결과 30례환자균성공접수문정맥조영,기중1례미능통과협착적문정맥주간；기여29례중,25례행구낭확장후지가식입술,공식입26개자팽식지가；4례행구낭확장치료.개입치료적기술성공솔위96.7％(29/30).7례행곡장적위관상정맥탄황권전새.개입치료상관적병발증위흉막강출혈2례.수방기위1～72개월(평균21.5개월),소유접수개입치료환자적문정맥균통창,미출현지가내재협착.결론 개입치료간이식술후문정맥협착안전、유효,문정맥통창솔량호.
Objective To evaluate the effectiveness of the interventional treatment for portal vein stenosis in patients who had undergone liver transplantation.Methods From Apr.2004 to Oct.2011,30 patients with portal vein stenosis after liver transplantation were referred for angiographic analysis and interventional treatment. All patients had typical clinical signs and symptoms or surveillance by imaging.After percutaneous transhepatic portography and balloon angioplasty,stents were deployed.Embolization was performed on patients with varices or portal vein flow changes.The therapeutic results were monitored by the follow-up on clinical symptoms,laboratory tests and imaging examinations.Results Angiography was performed successfully on all patients.Twenty-four patients received balloon dilation and 26 stents were deployed subsequently.The guide-wire cannot pass through the lesion of portal trunk in 1patient.Four patients received balloon angioplasty only.The technical success rate was 96.7％ (29/30).Stainless steel coils were applied in 7 patients for varices embolization.The complication related to interventional treatment was bleeding in thoracic cavity which happened in 2 patients.Portal vein patency was maintained in all the patients who received interventional treatment for 1-72 months (mean 21.5 months).No re-stenosis was identified.Conclusion Interventional therapy is an effective method for the treatment of portal vein stenosis after liver transplantation and excellent patency can be achieved by this method.