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1、第5卷第2期器官移植V01.5No.22014年3月OrganTransplant~ionMar.2014·臨床研究·超聲檢查在活體肝移植受體術(shù)后膽道并發(fā)癥診斷中的應(yīng)用廖梅任杰鄭榮琴呂艷【摘要】目的探討超聲檢查在活體肝移植術(shù)后膽道并發(fā)癥診斷中的臨床應(yīng)用。方法對(duì)21例成人右半肝活體移植受體術(shù)后進(jìn)行超聲檢查,觀察移植肝及其膽道聲像圖表現(xiàn),與經(jīng)皮經(jīng)肝穿刺膽道造影引流(PTCD)等影像學(xué)結(jié)果相對(duì)比。結(jié)果21例病例經(jīng)PTCD及臨床隨訪證實(shí)為膽管吻合I=1狹窄5例,膽泥1例,膽漏1例。超聲檢查能夠診斷并與之相符5例,為4例吻合口狹窄及1例膽泥,膽漏病例可見肝周積液。其中4例膽管吻合I=1狹窄病例
2、超聲診斷時(shí)間均明顯早于臨床出現(xiàn)黃疸或血清膽紅素升高的時(shí)間。結(jié)論在活體肝移植術(shù)后膽道并發(fā)癥的診斷中,超聲檢查操作簡(jiǎn)便、無創(chuàng)、可重復(fù)性強(qiáng)、準(zhǔn)確性較高,可早期診斷膽管并發(fā)癥,具有重要的臨床應(yīng)用價(jià)值?!娟P(guān)鍵詞】肝移植,活體;超聲;膽道并發(fā)癥;診斷【中圖分類號(hào)】R617【文獻(xiàn)標(biāo)志碼】A【文章編號(hào)】1674~445(2014)02—0006-05ApplicationofuItras0n0graphyinevaluatingbiliarycomplicationsafterlivingdonorlivertransplantationLiaoMei,RenJie,ZhengRongqin,MYa
3、h.DepartmentofUltrasonography,theThirdAfiliatedHospitalofSunYat—sene,Guangzhou510630,ChinaCorrespondingauthor:RenJie,Email:re彬eguangzhou@126.COrn【Abstract】ObjectiveToinvestigatetheclinicalapplicationofuhrasonographyinthediagnosisofbiliarycomplicationsafterlivingdonorlivertransplantation(LDLT).M
4、ethodsUhrasonographywasusedin21casesafterrightliverLDLT.Theuhrasoundimagesoftransplantedliverandbiliarytractwereobservedandcomparedwiththeresultofpercutaneoustranshepaticcholangiographyanddrainage(PTCD).ResultsBiliarycomplicationswereidentifiedin7ofthe21easesbyPTCDandclinicalfollowup.Anastomoti
5、cstricturewasdetectedin5cases,bileleakagein1case,andbilesludgein1case.Fivecaseswereaccuratelydiagnosedbyultrasound,including4caseswithanastomoticstrictureand1easewithbilesludge.Effusionsurroundingliverwasobservedinthecasewithbileleakagebyultrasound.Moreover,thetimewhenanastomoticstricturewasdia
6、gnosedbyultrasoundwasearlierthanthatwhenjaundiceappearedorserumbilirubinincreasedin4cases.ConclusionsUhrasonographyisamethodwithconvenience,non—invasion,strongrepeatabilityandhighaccuracyindiagnosisofbiliarycomplicationsattheearlytimeafterLDLT,whichhasimportantvalueofclinicalapplication.【Keywor
7、ds】Livertransplantation,livingdonor;U1trasonography;Biliarycomplication;Diagnosis肝移植是目前治療終末期肝病最有效的手段。早期在臨床上無特異性表現(xiàn),確診依賴于膽道造影由于供肝缺乏,活體肝移植已經(jīng)在全球范圍內(nèi)逐漸等有創(chuàng)性影像學(xué)手段。超聲檢查是一種成熟的檢查發(fā)展成為最主要術(shù)式之一。膽道并發(fā)癥是活體肝移方法,具有簡(jiǎn)便、重復(fù)性好的優(yōu)點(diǎn),是肝移植術(shù)后植術(shù)后最常見的并發(fā)癥之一,文獻(xiàn)報(bào)道活體