CAJ | 학술논문

目的：探讨肝移植术后胆泥超声表现及其与预后的关系。方法回顾性分析36例肝移植术后胆泥患者的超声声像图表现，按治疗结果分为不良疗效组和疗效稳定组，比较两组间初次发现胆泥时的超声特点。结果缺血性胆道病变合并胆泥者在不良疗效组中占95％（19/20），在疗效稳定组中则仅为13％（2/16），差异有统计学意义（P＜0.05）。疗效稳定组的胆泥均位于肝门部（16/16），胆泥与胆管壁分界清晰（14/16），肝门部胆管壁无增厚（14/16），肝内胆管未见扩张（14/16）；不良疗效组胆泥分布范围广，除肝门部外，常累及肝内胆管（10/20），胆泥与胆管壁分界模糊（15/20），肝门部胆管壁增厚明显（16/20），肝内胆管扩张（19/20）；上述4项指标在两组间差异有统计学意义（均为P＜0.05）。结论在不同预后组间胆泥的声像图特点有差异，对合并有缺血性胆道病变超声特点的胆泥，提示预后较差，可能需要进行积极的介入治疗。
목적：탐토간이식술후담니초성표현급기여예후적관계。방법회고성분석36례간이식술후담니환자적초성성상도표현，안치료결과분위불량료효조화료효은정조，비교량조간초차발현담니시적초성특점。결과결혈성담도병변합병담니자재불량료효조중점95％（19/20），재료효은정조중칙부위13％（2/16），차이유통계학의의（P＜0.05）。료효은정조적담니균위우간문부（16/16），담니여담관벽분계청석（14/16），간문부담관벽무증후（14/16），간내담관미견확장（14/16）；불량료효조담니분포범위엄，제간문부외，상루급간내담관（10/20），담니여담관벽분계모호（15/20），간문부담관벽증후명현（16/20），간내담관확장（19/20）；상술4항지표재량조간차이유통계학의의（균위P＜0.05）。결론재불동예후조간담니적성상도특점유차이，대합병유결혈성담도병변초성특점적담니，제시예후교차，가능수요진행적겁적개입치료。
Objective To investigate the ultrasonograms of biliary sludge and its relationship with the prognosis of patients after liver transplantation.Methods Ultrasonograms of 36 patients with biliary sludge after liver transplantation were retrospectively analyzed.These patients were divided into two groups according to the different treatment outcomes:poor prognosis group and favorable prognosis group.The characteristics of initial ultrasonograms of biliary sludge when they were found at first time compared between two groups .Results Biliary sludge combined with ischemic-type biliary lesions accounted for 95% ( 19/20 ) in poor prognosis group while 13%(2/16)in favorable prognosis group.There was significant difference between two groups (P<0.05).In favorable prognosis group , biliary sludge was found locating in hepatic hilar region in all 16 cases (16/16) and the sludge had clear boundaries dissociated with bile duct walls were observed in 14 cases (14/16).There was no incrassation of bile duct walls in hepatic hilar region , nor dilation of intrahepatic bile ducts observed in 14 cases ( 14/16 ).In poor prognosis group , biliary sludge was observed widespread not only in hepatic hilar region but also in intrahepatic biliary ducts in 10 cases ( 10/20 ) , and the boundaries between sludge and bile duct walls were vague in 15 cases (15/20).Obvious incrassation of bile duct walls in hepatic hilar region was observed in 16 cases (16/20), and dilation of intrahepatic bile ducts was observed in 19 cases (19/20).There were significant differences in the above 4 ultrasound features between two groups (all in P<0.05).Conclusions There are differences in the ultrasonograms of biliary sludge between different prognosis groups.Biliary sludge combined with ischemic-type biliary lesions suggests a poor prognosis , which may need more active interventional treatments.