摘要
肝移植术后非闭塞性肝动脉低灌注(NHAHP)在临床上并不少见,通常发生于肝移植术后的30 d内;NHAHP会导致移植肝缺血、损伤,甚至失功能。NHAHP的发生机制尚不完全明确,可能有以下多种机制共同参与:脾动脉盗血、门静脉高灌注、及其所致的肝动脉血流反应性降低、肝动脉血流阻力指数增加等。NHAHP的临床表现和实验室检查均缺乏特异性。虽然DSA是诊断NHAHP的金标准,但其为有创检查,只用于需要腔内介入治疗的患者;彩色多谱勒血流图联合超声造影是目前首选的影像学检查手段。脾动脉主干栓塞是治疗NHAHP的首选方法,其安全有效,能够迅速改善NHAHP。
Clinically, nonocclusive hepatic arterial hypoperfusion(NHAHP) after liver transplantation is not uncommon and it usually occurs within 30 days after liver transplantation. NHAHP can lead to ischemia, injury, and even dysfunction of the transplanted liver. The mechanism of NHAHP is not completely clear, and the following several mechanisms may be together involved in the occurrence of NHAHP: splenic arterial steal syndrome, portal vein hyperperfusion, increased hepatic artery blood flow resistance index, and reduced hepatic artery blood flow caused by portal vein hyperperfusion. Both the clinical manifestations and laboratory tests of NHAHP have no specificity. Digital subtraction angiography is the gold standard for the diagnosis of NHAHP, but it is technically invasive and usually it is only adopted in patients who requires endovascular interventional therapy. At present, color Doppler flow pattern combined with contrast-enhanced ultrasound is the preferred imaging examination method. Splenic artery embolization is the preferred treatment for NHAHP, which is clinically safe and effective and can quickly improve NHAHP.(J Intervent Radiol,2022, 31: 738-740)
作者
余海洋
王凯
李绍钦
贾中芝
YU Haiyang;WANG Kai;LI Shaoqin;JIA Zhonghi(Department of Interventional and Vascular Surgery,Afiliated Changzhou Municipal No.2 People's Hospital of Nanjing Medical University,Changzhou,Jiangsu Province 213003,China)
出处
《介入放射学杂志》
CSCD
北大核心
2022年第7期738-740,共3页
Journal of Interventional Radiology
关键词
肝移植
肝动脉
脾动脉盗血
门静脉
灌注
liver transplantation
hepatic artery
splenic artery steal syndrome
portal vein
perfusion
