摘要
目的研究肝移植术后胆道铸型综合征（BCS）的放射介入治疗，总结治疗经验。方法回顾性分析2002年4月至2006年4月间的103例肝移植术后BCS受者的临床资料。根据纤维胆道镜下胆道上皮病变程度不同，将BCS受者分成轻度组32例、中度组53例和重度组18例。所有受者均进行不同程度的放射介入治疗，对各组治疗前、后的指标数据进行比较，并观察治疗效果。结果轻、中度组治疗后症状明显好转，各项肝功能指标与治疗前比较，差异有统计学意义（P〈0．05）；重度组症状无明显改变。随访12个月，轻度组未发现非吻合口狭窄；中度组12例因支撑管移位而出现坏死部位轻到中度狭窄；重度组在观察期内严重狭窄的发生率达100％，均出现严重的梗阻性黄疸。结论对轻、中度BCS受者，放射介入治疗效果较好；重度BCS受者应尽早行2次肝移植手术。
Objective To investigate the ratiation interventional therapy to biliary cast syndrome （t3CS） after othotopic liver transplantation （OLT） and summarize the experience. Methods The radiation interventional therapy and prognosis of 103 patients with BCS after OLT were retrospectively analyzed. According to the severity of the lesions in biliary duct epithelium observed under the fiber choledochoscopy, patients were devided into 3 groups. There were 32 cases in mild group, 53 cases in moderate group and 18 cases in severe group. Serum ALT, GGT, ALP, Tbil and DBil were determined before and one week after treatment. The therapeutic efficacy was observed. Results The symptom was obviously improved and the biochemical indicators above in serum were signifcantly decreased after treatment as comapred with those before treatment in mild group and moderate group （P〈0. 05）. The symptom had no obvious change in severe group. After follow-up for 12 months, no non-anastomotic biliary stricture was found in the mild group, but in moderate group, 12 patients had mild to moderate biliary strictures because of the displacement of the supporting tube and the strictures were eliminated by replacement of the tube, and in the severe group, the occurrence of severe stricture was 100 % and severe obstructive jaundice occurred in all patients. Conclusions The radiation interventional therapy was an important assistant treatment for the mild and the moderate BCS. Retransplantation must be performed as early as possible on the pateints with severe t3CS.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2008年第2期98-101,共4页
Chinese Journal of Organ Transplantation
关键词
肝移植
胆道疾病
放射学
介入性
治疗
Liver transplantation
Biliary tract diseases
Radiology, interventional
Treatment
