CAJ | 학술논문

目的总结肝移植术后迟发性门静脉血栓形成的治疗方法,并分析其预后.方法单中心3100例次尸体全肝移植中发生迟发性门静脉血栓形成12例,发生时间平均为移植术后29.8个月.12例中,2例合并严重胆道并发症(肝内胆道狭窄),2例表现为移植肝功能衰竭,1例影像学检查可见肝门部肿物致门静脉受压,均接受再次肝移植;2例表现为急性上消化道出血,分别行经胃镜下套扎、注射硬化剂治疗;余5例无任何临床表现,口服抗凝或抗血小板药物治疗.结果 12例中,除1例失访外,其他患者至随访结束时存活8例,包括2例行再次肝移植者.存活者肝功能检查结果均正常.结论肝移植术后发生迟发性门静脉血栓形成,应根据患者的临床表现不同采用不同的治疗方法.
목적 총결간이식술후지발성문정맥혈전형성적치료방법,병분석기예후.방법 단중심3100례차시체전간이식중발생지발성문정맥혈전형성12례,발생시간평균위이식술후29.8개월.12례중,2례합병엄중담도병발증(간내담도협착),2례표현위이식간공능쇠갈,1례영상학검사가견간문부종물치문정맥수압,균접수재차간이식;2례표현위급성상소화도출혈,분별행경위경하투찰、주사경화제치료;여5례무임하림상표현,구복항응혹항혈소판약물치료.결과 12례중,제1례실방외,기타환자지수방결속시존활8례,포괄2례행재차간이식자.존활자간공능검사결과균정상.결론 간이식술후발생지발성문정맥혈전형성,응근거환자적림상표현불동채용불동적치료방법.
Objective To summary therapeutic method for delayed portal vein thrombosis after liver transplantation. Methods In 3100 cases undergoing cadaveric whole liver transplantation in a single center, there were 12 cases of delayed portal vein thrombosis after liver transplantation.Average occurring time was 29. 8 months after liver transplantation. Among these 12 patients, 2 cases were complicated with severe biliary complication (intrahepatic stricture) , 2 cases presented with liver failure of transplanted liver, and one case had portal vein compression by hepatic hilum tumor under the image examination, who received liver re-transplantation; two patients presented upper gastrointestinal bleeding, and they experienced endoscopic ligation and sclerotherapy respectively; the rest five patients without any clinical presentation were subjected to anticoagulation and antiplatelet therapy. Results Among 12 cases, 8 patients survived by the time of follow-up, including two patients undergoing re-transplantation; one patient lost follow-up. The liver function tests of the patients who survived were all normal. Conclusion The individualized therapeutic methods should be adopted for the patients with delayed portal vein thrombosis after liver transplantation.