摘要
目的:通过对病例资料的回顾性分析,验证微创介入性超声技术在肝移植术后并发症诊断和治疗中的价值。方法:选择2003-04/2006-11在解放军八一医院应用介入性超声技术诊治原位肝移植术后并发症的患者64例,患者均知情同意。根据病变部位选择合适体位,局部麻醉后,彩超引导最佳穿刺径路,用18G穿刺针或自动活检针对病灶进行细胞组织学穿刺活检。通过介入性超声下的影像学变化,对各种原位肝移植术后并发症作出评估诊断及治疗。结果:64例患者全部进入结果分析,无脱落。①超声引导下肝活检28例,穿刺成功率100%,其中排异反应16例。②彩色超声引导下诊断及介入治疗47例,其中腹腔出血3例,经皮经肝胆管引流4例,肝门部及膈下脓肿抽吸引流5例,胆漏置管引流4例,胸腹水置管引流5例,抽吸胸腹水26例。③误诊肝动脉血栓1例。④所有患者介入治疗后并发症症状均有不同改善,无复发。结论:介入性超声对正确诊断及治疗肝移植术后胸腹腔并发症具有重要的临床价值。
AIM： To investigate the clinical value of interventional ultrasound in the diagnosis and treatment of postoperative complications of liver transplantation through retrospectively analyzing the case data. METHODS： Sixty-four patients administrated with orthotopic liver transplantation were diagnosed and treated with interventional ultrasound in 81 Hospital of Chinese PLA from April 2003 to November 2006. The proper body position was identified according to the affected sites, and then the puncture pathway was guided by color ultrasound after local anesthesia with 18 G puncture pin or automatic biopsy needle for cytohistological biopsy of focus of infection. The postoperative complications of liver transplantation were evaluated and diagnosed through the imaging changes under interventional ultrasound. RESULTS： Totally 64 patients were involved in the result analysis with no loss. （1）Among 28 patients underwent liver biopsy, the successful rate of puncture was 100%, and 16 cases presented rejection. （2）Totally 47 cases were subjected to the diagnosis and interventional treatment under color ultrasound, of which, 3 cases were diagnosed as abdominal bleeding, 4 with percutaneous transhepatic cholangial drainage, 5 with malignancy effusion drained with tube, 4 as bUiary fistula, and 5 as hepatic portal apostema, and 26 cases were aspirated directly under the guidance of ultrasound. （3）One case of hepatic artery thrombosis was misdiagnosed. （4）The complications in all patients were improved at different extents after interventional therapy with no relapse. CONCLUSION： The interventional ultrasound shows important clinical values in the diagnosis and treatment of postoperative complications in splanchnocoel of liver transplantation.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第38期7521-7524,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
