肝移植术后肝动脉血栓形成的治疗方法探讨

目的探讨肝移植术后肝动脉血栓形成的治疗方法。方法回顾性分析我院自2001年11月至2005年1月收治肝移植术后肝动脉血栓形成患者14例,分别采用动脉溶栓、血管支架植入、高压氧治疗及再次肝移植治疗。结果动脉溶栓11例,成功率45.5%(5/11),2例随访12个月肝功能正常,另3例均于随访期死亡,其中2例因吻合口狭窄曾行血管支架植入术。高压氧治疗3例,随访7个月,临床效果较好。急诊再次肝移植2例,术后均死于多器官功能衰竭。结论肝移植术后肝动脉血栓形成,动脉溶栓及血管支架植入治疗存在局限性,高压氧治疗效果良好,可与其他保守治疗联合使用,应避免急诊再次肝移植。

Treatment of hepatic artery thrombosis after liver transplantation

Objective To explore the treatment of hepatic artery thrombosis after liver transplantation.Methods The treatment of hepatic artery thrombosis in 14 patients after liver transplant in our hospital from November 2001 to January 2005 was analyzed retrospectively.Results 11 patients were treated with thrombolytic therapy and the successful rate was 45.5%(5/11).2 patients had normal liver function and the other 3 died during a follow-up of 12 months.2 patients were treated with stent placement.Hyperbaric oxygen(HBO) treatment was performed in 3 patients,and 1 patient obtained good curative effect during a follow-up of 7 months.2 patients underwent re-transplantation and died of multiple organ dysfunction.Conclusions Intra-arterial thrombolytic therapy and stent placement are not so effective as hyperbaric oxygen therapy in the treatment of hepatic artery thrombosis after liver transplantation,and re-transplantation should be avoided.