摘要目的 总结肝移植术后门静脉系统血栓形成的临床特点及诊疗体会.方法 回顾2003年1月至2007年2月期间402例接受肝移植患者的临床资料,对其中9例肝移植术后门静脉系统血栓形成的原因、预后及诊治方案进行回顾性分析.结果 9例患者均接受全身抗凝、祛聚治疗,其中1例行经皮腔内血管成形术并血管内支架置入术、1例行经皮门静脉置管溶栓并再次肝移植、1例行外科手术取栓治疗.有6例患者分别于术后9、30、34、40、48、62d死于多器官功能衰竭,3例长期存活.结论 门静脉病变、血流状态改变、高凝状态及手术操作不当是造成术后门静脉血栓形成的主要原因,对高危患者进行预防性治疗,对已形成的病变早期诊断,积极的综合性干预是提高预后的关键.

abstractsObjective To investigate and summarize the experience in clinical presentation,diagnosis and treatment of portal vein thrombosis after orthotopic liver transplantation(OLT).Methods The clinical data of 402 patients who underwent OLT from January 2003 to February 2007 were reviewed.A retrospective study was performed on etiology,prognosis and treatment in 9 cases of portal vein thrombosis after OLT.Results All of the 9 cases received anticoagulant and antiaggregation therapy,within whom one underwent percutaneous transluminal angioplasty and stent placement,one underwent retransplantation after failure of thrombolysis therapy,and one received surgical embolectomy.Six patients died of multiple organ failure on 9th,30th,34th,40th,48th,62th days,respectively,while 3 patients survived.Conclusions The major risk factors of portal vein thrombosis after OLT were pathological changes in portal vein,abnormal blood stream dynamics,hypercoagulable status and improper surgical technique.Prophylactic intervention to patients with high risk factors,early diagnosis and aggressive comprehensive therapy on portal vein thrombosis patients are essential to improve prognosis.