CAJ | 학술논문

目的：评价普通彩色多普勒血流显像（CDFI）技术在小儿肝移植术后早期肝动脉栓塞（HAT）中的诊断价值。方法回顾性分析2005年4月至2014年5月在武警总医院施行的55例小儿肝移植病例的临床资料。对所有病例在术后早期应用CDFI技术进行常规血流监测。经CDFI多切面检查于肝内未见肝动脉血流信号拟诊HAT，对怀疑HAT者进行计算机体层摄影术血管造影（CTA）检查或手术探查。应用Chiss统计软件，计算普通CDFI技术诊断HAT的灵敏度和特异度。结果55例小儿肝移植受者中，CDFI检查共拟诊3例HAT，其中2例为肝动脉主干栓塞，1例为肝右动脉栓塞，均经CTA检查和手术探查证实诊断。本组病例HAT发生率为5％（3/55）。应用普通CDFI 技术诊断小儿肝移植术后HAT的灵敏度为1.0、特异度为1.0、假阳性率为0。结论普通CDFI技术为小儿肝移植术后血流动力学检测首选的、最主要的检查手段，经验丰富的移植超声医师实施检查可提高诊断HAT的准确性。
목적：평개보통채색다보륵혈류현상（CDFI）기술재소인간이식술후조기간동맥전새（HAT）중적진단개치。방법회고성분석2005년4월지2014년5월재무경총의원시행적55례소인간이식병례적림상자료。대소유병례재술후조기응용CDFI기술진행상규혈류감측。경CDFI다절면검사우간내미견간동맥혈류신호의진HAT，대부의HAT자진행계산궤체층섭영술혈관조영（CTA）검사혹수술탐사。응용Chiss통계연건，계산보통CDFI기술진단HAT적령민도화특이도。결과55례소인간이식수자중，CDFI검사공의진3례HAT，기중2례위간동맥주간전새，1례위간우동맥전새，균경CTA검사화수술탐사증실진단。본조병례HAT발생솔위5％（3/55）。응용보통CDFI 기술진단소인간이식술후HAT적령민도위1.0、특이도위1.0、가양성솔위0。결론보통CDFI기술위소인간이식술후혈류동역학검측수선적、최주요적검사수단，경험봉부적이식초성의사실시검사가제고진단HAT적준학성。
Objective TostudythevalueofordinarycolorDopplerflowimaging(CDFI)inthe diagnosis of hepatic artery thrombosis (HAT)in early stage after pediatric liver transplantation (PLT).Methods Clinicaldataof55childrenundergoingPLTintheGeneralHospitalofChinesePeople'sArmed Police Forces from April 2005 to May 2014 were analyzed retrospectively. Conventional hemodynamic monitoring was performed in all cases in the early stage after operation by CDFI. No intrahepatic arterial blood flow signal was observed by CDFI multi-angle examination and HAT was suspected. Computed tomography angiography (CTA)and surgical exploration were performed in the suspected HAT patients. The sensitivity and specificityofordinaryCDFIindiagnosingHATwerecalculatedbyChissstatisticalsoftware.Results Among the 55 PLT recipients,3 cases were suspected as HAT by CDFI,including 2 cases of HAT in the main hepatic artery,1 cases of HAT in the right hepatic artery. All cases were confirmed by CTA or surgical exploration.The incidence of HAT was 5% (3/55 ). The sensitivity and the specificity of CDFI in diagnosing HAT after PLTwereboth1.0,andfalsepositiveratewas0.Conclusions OrdinaryCDFIisthepreferredandmain method for hemodynamic examination after PLT. The experienced sonographer for transplantation can improve the accuracy in diagnosing HAT.