[1]马朝来　 张同琳　 宋世兵　 袁炯　 修典荣　 李选①　 朱建平　 王德臣　 蒋斌.肝移植术后肝动脉血栓形成的溶栓治疗3例报道[J].中国微创外科杂志,2003,03(3):206-208.
　Ma Zhaolai,Zhang Tonglin,Song Shibing,et al.Intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver trAnsplantation[J].Chinese Journal of Minimally Invasive Surgery,2003,03(3):206-208.
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肝移植术后肝动脉血栓形成的溶栓治疗3例报道()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
03
期数:
2003年3期
页码:
206-208
栏目:
新技术新方法
出版日期:
2003-03-31

文章信息/Info

Title:
Intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver trAnsplantation
作者:
马朝来　 张同琳　 宋世兵　 袁炯　 修典荣　 李选①　 朱建平　 王德臣　 蒋斌
北京大学第三医院普通外科,北京,100083
Author(s):
Ma Zhaolai; Zhang Tonglin; Song Shibing; et al.
Department ofGeneral Surgery,Peking UniversityThirdHospital,Beijing100083,China
关键词:
肝动脉血栓形成;  肝移植;  介入治疗
Keywords:
Hepatic artery thrombosis; 　Liver transplantation; 　Interventional procedure
分类号:
R654.305
文献标志码:
B
摘要:
目的探讨肝移植术后肝动脉血栓形成的溶栓治疗价值. 方法对50例同种异体肝移植病例,术后以彩色多普勒超声(CDI)定期监测肝动脉血流,怀疑肝动脉血栓形成(HAT)者行动脉造影,确诊3例,即刻行介入溶栓治疗, 经导管分别在20分钟内予尿激酶12.5万单位、30分钟内予尿激酶25万单位和肝素50mg,及4小时内注入尿激酶60万单位. 结果 3例溶栓治疗后,肝动脉均再通.1例因二次血栓形成再次溶栓成功.但均发生不同程度的腹腔内出血,1例保守治疗痊愈,1例经开腹手术止血后痊愈,另1例死于多器官功能衰竭. 结论对怀疑HAT病例,应尽早行动脉造影.改进后的溶栓疗法有可能成为治疗HAT的可选择方法.
Abstract:
Objective　To explore the clinical value of intra-arterial thrombolysis for hepatic artery thrombosis after liver transplanta- tion.　Methods　Routine color Doppler imaging (CDI) was used to detect the hepatic artery thrombosis (HAT) after liver transplantation in 50 cases. Suspected patientswere further confirmed by immediate angiography. Three cases ofHATwere treated by intra-arterial thrombolys- is: infusion of 125,000U urokinase within 20 minutes, 250,000U urokinase and 50mg heparin within 30 minutes, and 600,000U urokinase within 4 hours, respectively.　Results　Hepatic artery recanalization was obtained in all 3 cases. A second HAT occurred in 1 case, in which a second intra-arterial thrombolysis was successfully completed. Intra-abdominal hemorrhage, however, was found in all 3 cases: 1 patient was cured by preservative treatment, 1 was cured by hemostatic laparotomy and the rest 1 died of multiple system organ failure after he- mostatic operation.　Conclusions　Angiogrhphy should be used as early as possible in suspectedHAT cases. Improved intra-arterial throm- bolytic therapy may be a promising method in the treatment of HAT.

参考文献/References:

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［2］Mor E, Schwartz ME, Sheiner PA, et al. Prolonged preservation in University of Wisconsin solution associated with hepatic artery thrombosis after orthotopic liver transplantation. Transplantation, 1993,56: 1399-1402.
［3］Orons PD, Zajko AB. Angiography and interventional procedures in liver transplantation. Radiol Clin North Am,1995,33:541-558.
［4］Hidalgo EG, Abad J, Cantarero JM, et al. High-dose intra-arterial urokinase for the treatment of hepatic artery thrombosis in liver transplantation. Hepatogastroenterology,1989,36: 529-532.
［5］谷川,沈中阳,郝明利,等. 原位肝移植70例报告. 中华器官移植杂志,2001,22:75-77.6.Figueras J, Busquets J, Diminguez J, et al. Intra-arterial thrombosis in the treatment of acute hepatic artery thrombosis after liver transplantation. Transplantation,1995,59:1356-1357.

备注/Memo

备注/Memo:
①放射科
更新日期/Last Update: 2014-06-10