Abstract:

Objective To investigate the ultrasound imaging characteristics and risk factors of lower extremity deep vein thrombosis（DVT）formation after liver transplantation. Methods A total of 141 patients who underwent liver transplantation in our hospital were selected，all of them received lower extremity veins examination by ultrasonography before operation，and the presence or absence of DVT was recorded. The occurrence of DVT at 1，7，and 14 d after operation was monitored. The sex，age，hypertension，diabetes mellitus，tumor history，history of long-term alcohol consumption，cholesterol concentration，triglyceride concentration，HDLconcentration，LDL concentration，D-dimer concentration，history of lower extremity deep venipuncture tube placement，total operation time，duration of anhepatic phase，intraoperative blood loss and blood transfusion，MELD score were analyzed. Results DVT was not detected before transplantation; DVT was detected in 33 cases after operation，and the overall incidence of DVT was 23.4%. All occurred within 7 d after operation. Univariateregression analysis showed that there were significant differences in total cholesterol concentration，high density lipoprotein concentration，D-dimer concentration，intraoperative bleeding and blood transfusion，MELD score，tumor history and lower extremity deep vein puncture and catheterization between patients wito or without DVT （P ＜ 0.05）. Logistic multivariate regression analysis showed that the history of lower extremity deep vein puncture，high MELD score and high D-dimer concentration were the risk factors of DVT after liver transplantation（P ＜ 0.05）. Conclusion Ultrasound can clearly diagnose the formation of lower limb DVT after liver transplantation. Totalcholesterol concentration，high density lipoprotein concentration，D-dimer concentration，intraoperative bleeding and blood transfusion，MELD score，tumor history and lower limb deep vein puncture and catheterization history are important factors for the formation of DVT. Ultrasound monitoring should be focused on patients with the above high-risk factors.

Key words:

"> Ultrasound； Liver transplantation； Deep vein thrombosisfunction

摘要：

目的 探讨肝移植术后下肢深静脉血栓（deep vein thrombosis，DVT）的超声影像特征和 DVT形成的危险因素。方法 选取深圳市第三人民医院行肝移植手术患者 141 例，术前均采用超声检查下肢静脉，记录有无 DVT，术后 1、7、14 d 复查 DVT 发生情况。分析性别、年龄、高血压、糖尿病、肿瘤史、长期饮酒史、胆固醇浓度、甘油三酯浓度、高密度脂蛋白浓度、低密度脂蛋白浓度、D- 二聚体浓度、下肢深静脉穿刺置管史、总手术时间、无肝期时间、术中出血量及输血量、终末期肝病模型（model for end-stage liver disease，MELD）评分对肝移植术后 DVT 形成的可能风险因素。结果 移植术前均未检出 DVT，术后检出 DVT 33 例，DVT 总体发生率为 23.4%。均发生于术后 7 d 内。单因素回归分析显示，无 DVT 者与 DVT 者总胆固醇浓度、高密度脂蛋白浓度、D- 二聚体浓度、术中出血量及输血量、MELD 评分、肿瘤史、下肢深静脉穿刺置管比较差异均有统计学意义（均 P ＜ 0.05）。Logistic 多因素回归分析显示，下肢深静脉穿刺史、高 MELD 评分及高 D- 二聚体浓度是肝移植术后 DVT 形成的危险因素（均 P ＜ 0.05）。结论 超声可以明确诊断肝移植术后下肢 DVT 形成，总胆固醇浓度、高密度脂蛋白浓度、D- 二聚体浓度、术中出血量及输血量、MELD 评分、肿瘤史、下肢深静脉穿刺置管史是 DVT 形成的重要因素，对有以上高危因素的患者应重点进行超声监测。

关键词:

超声 , 肝移植 , 深静脉血栓