摘要
目的探讨肝移植术后患者门静脉血栓(PVT)发生的病因。方法回顾性分析2015年11月至2019年2月解放军总医院第五医学中心401例肝移植患者临床资料,分析肝移植后发生PVT的病因。结果401例肝移植患者中,15例出现PVT,发生率为3.7%,男性9例,女性6例,平均年龄50.8岁(35~63岁)。术前乙肝肝硬化9例、丙肝肝硬化1例、乙丙重叠感染肝硬化1例、自身免疫性肝炎肝硬化2例、肝豆状核变性1例,酒精性肝硬化1例。15例门静脉血栓患者中,术前存在血栓12例(80%)、脾切除或脾栓塞手术史4例(26.7%)、门腔分流3例(20%),经有效治疗后,血栓得到明显缓解。结论PVT是肝移植后并不常见的血管并发症,多普勒超声检查是监测门静脉并发症的首选有效方法,应早发现,进行个体化治疗。
Objective To investigate the etiology and prognosis of portal vein thrombosis(PVT)after liver transplantation(LTx).Methods The clinical data of 401 orthotopic liver transplantation patients in our center were reviewed and the etiology of PVT after LTx was analyzed.Results The incidence of PVT was 3.7%(15/401)in 15 LTx patients,including 9 males and 6 females,with an average age of 50.8 years(35-63 years).There were 9 cases of hepatitis B cirrhosis,1 case of hepatitis C cirrhosis,1 case of hepatitis B-C overlapping infection cirrhosis,2 cases of autoimmune hepatitis cirrhosis,1 case of hepatic lenticular degeneration,and 1 case of alcoholic cirrhosis.Among the 15 patients with PVT,12 cases had preoperative thrombosis(80%),4 cases had splenectomy or splenic embolization operation history(26.7%),and 3 cases had portal-luminal shunt(20%).After effective treatment,the thrombosis was significantly relieved.Conclusion PVT is a rare vascular complication after LTx.Color Doppler Ultrasonography is the first choice and effective method for monitoring portal vein complications.Early detection and individualized treatment can achieve safe and effective efficacy.
作者
李丽昕
李志杰
白瑛
刘鸿凌
李洪苓
任敏娟
安子瑞
刘振文
王洪波
LI Li-xin;LI Zhi-jie;BAI Ying;LIU Hong-ling;LI Hong-ling;REN Min-juan;AN Zi-rui;LIU Zhen-wen;WANG Hong-bo(Department of Liver Transplantation,the Fifth Medical Center of PLA General Hospital,Beijing 100039,China)
出处
《肝脏》
2021年第9期1016-1018,1051,共4页
Chinese Hepatology
基金
首都市民健康培育(Z161100000116058)。
关键词
肝移植
门静脉栓塞
并发症
Liver transplantation
Portal vein embolism
Complication
