摘要
目的探讨介入治疗肝移植术后肝动脉并发症患者的预后及影响预后的相关因素。方法回顾性分析21例肝移植术后发生肝动脉并发症，并接受肝动脉溶栓、腔内血管成形术（PTA）和（或）肝动脉支架置入术等治疗患者的临床资料，根据移植肝脏预后分为预后不良组和预后较好组，比较2组胆道并发症、肝动脉再狭窄、早期并发症或是晚期并发症等15项变量，采用二值Logistic回归分析方法筛选出影响介入治疗疗效的因素。结果21例患者平均随访时间为436d，中位随访时间464d（3～1037d）。其中预后不良组11例（5例再次肝移植，6例死亡），平均存活时间191d，中位存活时间为73d（3—616d）；预后较好组10例，移植肝平均存活时间706d，中位存活时间692d（245—1037d）。单因素分析两组患者差异有统计学意义的因素有：胆道并发症、血总胆红素水平以及间接胆红素水平；经Logistic回归分析显示，主要危险因素是胆道并发症（P=0．027，OR=22．818）。结论伴有胆道并发症，是影响肝移植术后肝动脉并发症患者介入治疗效果的主要因素。
Objective To investigate the prognosis and prognostic risk factors of hepatic artery complications after orthotopic liver transplantation （OLT） treated with the interventional techniques. Methods The clinical data of 21 patients with hepatic artery complication after liver transplantation receiving thrombolysis, PTA, and stent placement in our institute from November 2003 to April 2007 were retrospectively analyzed. Based on the prognosis of grafts, 21 patients were divided into poor-prognosis group and non-poor-prognosis group. Fifteen variables （including biliary complication, hepatic artery restenosis, early or late artery complication, and so on） were analyzed in both groups with binary logistic regression analysis to screen out the risk factors related to prognosis of percutaneous interventional treatment for hepatic artery complications after OLT. Results Twenty-one patients were followed for mean 436 days, median 464 days （3--1037 days）. The poor-prognosis group included 11 patients （5 eases received retransplantation, and 6 died）. The mean survival time of grafts in poor-prognosis group was 191 days, and median survival time was 73 days （3---616 days）. The mean survival time of grafts in non-poor-prognosis group which included 10 patients was 706 days, and median survival time was 692 days （245--1037 days）. Univariate analysis showed there were significant difference in biliary complication, total bilirubin and indirect bilirubin between the two groups. The binary logistic regression analysis showed the risk factor related to prognosis was with biliary complication before the interventional management （P = 0. 027, OR = 22. 818）. Conclusion Biliary complication before interventional management is the risk factor related to poor prognosis of patients with hepatic artery stenosis or thrombosis receiving interventional treatment.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2008年第11期1192-1195,共4页
Chinese Journal of Radiology
基金
广东省自然科学基金研究团队资助项目（05200177）
关键词
肝移植
手术后并发症
肝动脉
放射学
介入性
预后
Liver transplantation
Postoperative complications
Hepatic artery
Radiology, interventional
Prognosis
