超声检查在儿童肝移植术后胆道并发症诊断中的应用价值

摘要

目的探讨超声检查在儿童肝脏移植术后胆道并发症诊断中的应用价值。方法对185例儿童肝移植受者术后进行超声检查，观察患儿移植肝及胆管超声声像图表现，与磁共振胰胆管成像（ MRCP）、经皮经肝穿刺胆道造影引流（ PTCD）等胆道造影结果相对比，分析超声检查在儿童肝移植术后胆道并发症诊断的准确性。结果185例病例经 MRCP、PTCD、诊断性治疗及术后随访证实有胆泥20例，胆漏12例，胆管吻合口狭窄13例。超声检查能够诊断并与之相符39例，其中胆泥16例，胆漏10例，胆管吻合口狭窄13例。结论在儿童肝移植受者术后胆道并发症的诊断中，超声作为一种无创、操作简便的检查方法，具有较高的准确性及临床应用价值。%Objective To investigate the clinical application of ultrasonography in the diagnosis of biliary complications after pediatric liv-er transplantation. Methods Ultrasonography was used in 185 cases after pediatric liver transplantation. The ultrasound images of transplanted liver,hepatic and biliary tract were observed and compared with the result of magnetic resonance cholangiopancreatography( MRCP),percutane-ous transhepatic cholangiography and drainage( PTCD),to analyze the accuracy of ultrasonography in the diagnosis of biliary complications after pediatric liver transplantation. Results Biliary complications were identified in 45 of the 185 cases by PTCD and clinical follow up. Bile sludge was detected in 20 cases,anastomotic stricture in 13 case,and bile leakage in 12 case. 39 cases were accurately diagnosed by ultrasound,inclu-ding 16 cases with bile sludge,13 cases with anastomotic stricture and 10 cases with bile leakage. Conclusion Ultrasonography is a method with non-invasion and convenience in diagnosis of biliary complications after pediatric liver transplantation,which has high accuracy and clinical ap-plication value.