摘要
目的:探讨多普勒超声评价小儿左外叶活体肝移植术后早期移植肝血流参数的正常变化规律,并分析各参数正常参考范围。方法:回顾性收集261例自2014年6月至2018年1月于天津市第一中心医院器官移植中心进行亲体捐献肝脏左外叶移植手术患儿的临床资料及术后早期移植肝多普勒血流参数,多普勒血流参数包括肝动脉收缩期峰值流速(peak systolic velocity,PSV HA)、肝动脉舒张期流速(end diastolic velocity,EDV HA)、肝动脉阻力指数(resistivity index,RI HA)、肝动脉搏动指数(pulsation index,PI HA)、门静脉流速(portal vein velocity,PVV)。其中232例术后血清肝功能指标转归良好且无血管并发症纳入本研究,按照入组时间先后顺序分为实验组(200例)和验证组(32例)。在实验组,分析患儿术中及术后第1 d、第3 d、第5 d、第7 d血流参数的变化趋势及其正常参考范围,所得结果在验证组进行验证。结果:(1)实验组:①PSV HA、EDV HA变化趋势相同,整体呈降低-升高趋势,术后第3 d明显低于术中及术后第1 d,术后第5、7 d明显高于术后第3 d,差异有统计学意义(均P<0.01);②RI HA、PI HA于术后变化趋势相同,整体呈升高-降低趋势,术后第1、3 d明显高于术中,术后第5、7 d明显低于术后第1、3 d,差异有统计学意义(均P<0.01);③PVV于术后各时间点高于术中(均P<0.01),且术后第7 d低于术后第5 d,差异有统计学意义(P<0.05);④所估算的移植肝血流参数正常参考范围,术中为PSV HA 18.4~98.3 cm/s、EDV HA 0~43.3 cm/s、RI HA 0.41~1.0、PI HA 0.51~2.0、PVV 19.0~83.7 cm/s,术后1周内为PSV HA 21.0~97.7 cm/s、EDV HA 0~32.7 cm/s、RI HA 0.47~1.0、PI HA 0.62~2.0、PVV 23.0~92.0 cm/s。(2)验证组:对血流参数变化趋势的验证,PSV HA、EDV HA、RI HA、PI HA、PVV变化趋势与实验组所得结果的符合率分别为84.3%(27/32)、84.3%(27/32)、78.1%(25/32)、78.1%(25/32)、87.5%(28/32);对血流参数正常参考区间的验证,验�
Objective To analyze hepatic hemodynamic parameters detected by Doppler ultrasound(DU)of uncomplicated children who underwent left lateral segment(LLS)LDLT(LLS-LDLT),explore their change trends over time and determine the normal reference intervals.Methods This retrospective study involved the data from 261 pediatric LLS-LDLT cases in Tianjin First Central Hospital from June 2014 to January 2018.Hemodynamic parameters included peak systolic velocity(PSV),end diastolic velocity(EDV),resistivity index(RI),and pulsation index(PI)of hepatic artery(HA),and portal vein velocity(PVV)during intra-operative and on the 1st,3rd,5th and 7th days after operation were collected.Among whom,232 cases with uncomplicated and normal recovery were finally involved in our study,with 200 cases who were collected from June 2014 to August 2017 as test group.Those collected from September 2017 to January 2018,totally 32 cases were set as validation group.The change trends and normal ranges of hemodynamic parameters over time were analyzed in test group,and the results were further tested in the validation group.Results In the test group,PSVHA,EDVHA showed a similar change trend at one week after surgery,with an overall decrease-rise trend;RIHA,PIHA also changed similarly with an overall rise-decrease trend.PVV at surgery was lower than at all time points after surgery.In addition,this study provided the normal reference intervals of hemodynamic parameters for LDLT patients at early postoperative period,which at intra-operation they were PSVHA 18.4-98.3 cm/s,EDVHA 0-43.3 cm/s,RIHA 0.41-1.0,PIHA 0.51-2.0,PVV 19.0-83.7 cm/s.Within 1 week after surgery:PSVHA 21.0-97.7 cm/s,EDVHA 0-32.7 cm/s,RIHA 0.47-1.0,PIHA 0.62-2.0,PVV 23.0-92.0 cm/s.By using those results,the coincidence rate of Doppler parameter change trend was 84.3%(27/32),84.3%(27/32),78.1%(25/32),78.1%(25/32),87.5%(28/32)for PSVHA,EDVHA,RIHA,PIHA,PVV in the validation group,respectively.As for the normal reference intervals of blood flow parameters,RIHA and PIHA in one case in the v
作者
唐缨
张国英
王明阳
王天驰
刘晓川
刘朴晶
刘东阳
张含
陈云
赵静雯
刘洋
刘菁
Tang Ying;Zhang Guoying;Wang Mingyang;Wang Tianchi;Liu Xiaochuan;Liu Pujing;Liu Dongyang;Zhang Han;Chen Yun;Zhao Jingwen;Liu Yang;Liu Jing(Department of Ultrasound,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第8期673-678,共6页
Chinese Journal of Ultrasonography
基金
天津市科技计划项目(18ZXZNSY00250)。
关键词
超声检查
小儿活体肝移植
肝左外叶
血流动力学
变化趋势
正常参考范围
Ultrasonography
Pediatric living donor liver transplantation
Liver left lateral segment
Hepatic hemodynamic
Changing trend
Normal reference interval
