肝移植术后门静脉并发症的诊断和治疗(附6例分析)

目的 探讨肝移植术后门静脉并发症的诊断和治疗。方法 回顾性分析160例原位肝移植临床资料。结果 肝移植术后门静脉并发症发生率为3．75％，与门静脉并发症相关死亡率为0。门静脉狭窄发生率为1．25％，门静脉栓塞发生率为2．5％，需治疗的门静脉并发症占33．3％。结论 术前有门脉高压症手术治疗史、移植术前门静脉血栓、门静脉手术史以及严重感染病史等是门静脉并发症的高危因素；彩色多普勒超声检查是监测门静脉并发症的有效方法，确诊门静脉并发症依赖门静脉造影；有症状的门静脉并发症需及时行再血管化手术。

Diagnosis and treatment of portal vein complications in liver transplantation: an analysis of 6 cases

Objective To study the diagnosis and treatment of portal vein complications in liver transplantation. Methods The clinical data of 160 patients receiving orthotopic liver transplantation (OLT) in our hospital from April 1993 to April 2002 were retrospectively analyzed. Results The incidence of portal vein complications was 3.75% and mortality related to the complications was 0. The incidence of portal vein stenosis was 1.25% and that of portal vein thrombosis was 2.5%. Of the complications, 33.3% had to be treated. Conclusions Previous treatment for portal hypertension, portal vein thrombosis, preoperative infection and severe infection are the risk factors for portal vein complications after OLT. Color Doppler imaging is a sensitive and specific method for monitoring the portal vein complications following liver transplantation. The angiography of portal vein is essential for diagnosis of the complications. Surgical revascularization should be performed in those patients with severe symptoms of portal vein complications.