中国医药
中國醫藥
중국의약
China Medicine
2015年
10期
1478-1480
,共3页
肝移植%肝动脉并发症%介入%介入放射学
肝移植%肝動脈併髮癥%介入%介入放射學
간이식%간동맥병발증%개입%개입방사학
Liver transplantation%Hepatic artery complications%Interventional%Interventional radiology
目的 评价介入技术在肝移植术后肝动脉并发症的诊断与治疗中的价值.方法 回顾性分析2005年5月至2015年4月北京大学人民医院8例肝移植术后肝动脉并发症患者介入诊断和治疗及随访资料.结果 肝动脉血栓形成6例,其中4例动脉溶栓后,发现伴肝动脉狭窄,2例重度狭窄者行肝动脉支架成形术,1例轻中度狭窄者仅予溶栓治疗,1例狭窄血管伴严重扭曲者溶栓治疗效果不佳,行开腹肝动脉切开取栓及吻合术;1例可见侧支循环建立,未予治疗;1例溶栓后血管通畅,未见狭窄.移植后脾动脉盗血综合征4例,行脾动脉栓塞术.肝动脉假性动脉瘤1例,行支架辅助动脉瘤栓塞术.随访1例肝动脉狭窄行动脉支架成形术患者术后5d因肝细胞广泛坏死行2次肝移植;余7例随访23 ～108个月肝功能均未见异常.结论 介入技术能有效地诊断和治疗肝移植术后肝动脉并发症.
目的 評價介入技術在肝移植術後肝動脈併髮癥的診斷與治療中的價值.方法 迴顧性分析2005年5月至2015年4月北京大學人民醫院8例肝移植術後肝動脈併髮癥患者介入診斷和治療及隨訪資料.結果 肝動脈血栓形成6例,其中4例動脈溶栓後,髮現伴肝動脈狹窄,2例重度狹窄者行肝動脈支架成形術,1例輕中度狹窄者僅予溶栓治療,1例狹窄血管伴嚴重扭麯者溶栓治療效果不佳,行開腹肝動脈切開取栓及吻閤術;1例可見側支循環建立,未予治療;1例溶栓後血管通暢,未見狹窄.移植後脾動脈盜血綜閤徵4例,行脾動脈栓塞術.肝動脈假性動脈瘤1例,行支架輔助動脈瘤栓塞術.隨訪1例肝動脈狹窄行動脈支架成形術患者術後5d因肝細胞廣汎壞死行2次肝移植;餘7例隨訪23 ～108箇月肝功能均未見異常.結論 介入技術能有效地診斷和治療肝移植術後肝動脈併髮癥.
목적 평개개입기술재간이식술후간동맥병발증적진단여치료중적개치.방법 회고성분석2005년5월지2015년4월북경대학인민의원8례간이식술후간동맥병발증환자개입진단화치료급수방자료.결과 간동맥혈전형성6례,기중4례동맥용전후,발현반간동맥협착,2례중도협착자행간동맥지가성형술,1례경중도협착자부여용전치료,1례협착혈관반엄중뉴곡자용전치료효과불가,행개복간동맥절개취전급문합술;1례가견측지순배건립,미여치료;1례용전후혈관통창,미견협착.이식후비동맥도혈종합정4례,행비동맥전새술.간동맥가성동맥류1례,행지가보조동맥류전새술.수방1례간동맥협착행동맥지가성형술환자술후5d인간세포엄범배사행2차간이식;여7례수방23 ～108개월간공능균미견이상.결론 개입기술능유효지진단화치료간이식술후간동맥병발증.
Objective To evaluate the value of intervention technique in diagnosing and treating hepatic artery complications after liver transplantation.Methods Data of 8 patients with hepatic artery complications after liver transplantation from May 2005 to April 2015 were retrospectively analyzed.Results Totally 6 patients had hepatic artery thrombosis;among them,hepatic artery stenosis was found after intra-arterial thrombolysis in 4 cases.Among them,2 cases had severe stenosis and underwent hepatic artery stent angioplasty;1 case had mild-moderate stenosis and underwent thrombolytic therapy;1 case had ineffective thrombolysis due to severe artery distortion and underwent hepatic artery embolectomy and anastomosis.The collateral circulation was established in 1 case and no treatment was given;no hepatic artery stenosis was found after intra-arterial thrombolysis in 1 case;1 patient had splenic artery steal syndrome and underwent splenic artery embolization;1 patient had hepatic artery pseudoaneurysm formation and underwent stent placement assisted aneurysm embolization.One case with hepatic artery stenosis who underwent hepatic artery stent angioplasty received repeated liver transplantation to extensive hepatocyte necrosis,and the liver functions were all normal in the other cases.Conclusion Intervention technique can diagnose and treat various hepatic artery complications after liver transplantation effectively.
