摘要
目的 探讨左外叶小儿活体肝移植术后门静脉、肝动脉血流变化及其与术后短期肝功能恢复的关系.方法 收集2006年6月-2013年3月在重庆医科大学附属儿童医院实施左外叶活体肝移植的17例患儿的临床资料.术后1~7天采用彩色多普勒超声诊断仪测定门静脉、肝动脉血流,检测患儿肝功能指标.分析门静脉、肝动脉血流变化趋势及与术后短期肝功能恢复的相关性.结果 (1)肝动脉血流量、血流量指数以及门静脉血流量、血流量指数变化与时间无关(P>0.05);肝动脉血流量、血流量指数与门静脉血流量、血流量指数变化无明显相关性(P>0.05);(2)移植物体重比(GRWR)与术后5、6、7天肝动脉血流量变化明显相关(P <0.05);GRWR与术后3~7天肝门静脉血流量变化明显相关(P<0.05);(3)术后第5天肝动脉血流量与同期AST变化呈负相关(r=-0.495,P<0.05);第3天及第5天门静脉血流量与同期AST变化呈负相关(r值分别为-0.525、-0.581,均P<0.05).结论 左外叶小儿活体肝移植术后肝动脉、门静脉血流量随GRWR增大明显增加;门静脉血流及肝动脉血流变化与术后短期肝功能恢复两者无明显相关性.
Objective To investigate the hemodynamic changes in the portal veins and hepatic arteries and in liver functions after left lateral section living donor liver transplantation (LDLT) in children.Methods The clinical data of 17 patients who underwent LDLT using the left lateral section from June 2006 to March 2013 were analyzed.The portal venous flow,hepatic arterial flow and liver functions were studied by color Doppler and laboratory tests from 1 to 7 days after the operations.The data were analyzed with SPSS 20.0.Results (1) There were no significant correlations between the hepatic arterial flow (HAF),hepatic arterial flow index (HFI),portal venous flow (PVF) or portal venous flow index (PFI) with time (P 〉 0.05).There was also no significant correlation between the HAF (HFI) with PVF (PFI) (P 〉 0.05);(2) However,the graft recipient body weight ratio (GRWR) was significantly correlated with HAF on post operative days (POD) 5,6 and 7 (P 〈 0.05),and also with PVF on POD 3-7 (P 〈 0.05);(3) There were no significant correlations between HAF and AST on POD 3 (r =-0.495,P 〈 0.05),and between PVFandASTonPOD3 and5 (r=-0.525,-0.581,P〈0.05).Conclusions PVF and HAF increased significantly with GRWR after operation.There was no significant correlation between PVF,HAF and liver function in this study.
出处
《中华肝胆外科杂志》
CSCD
北大核心
2017年第5期300-303,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
血流动力学
肝移植
肝动脉血流量
门静脉血流量
Hemodynamics
Liver transplantation
Hepatic arterial flow
Portal venous flow