常规超声和超声造影在肝移植术后活动性出血的诊断价值对比

doi:10.3969/j.issn.1009-976X.2021.06.006

岭南现代临床外科 ›› 2021, Vol. 21 ›› Issue (06): 620-624.DOI: 10.3969/j.issn.1009-976X.2021.06.006

常规超声和超声造影在肝移植术后活动性出血的诊断价值对比

赵宁波¹, 黄秀玲², 张瑜¹, 周丹¹, 李一君¹, 邓芬¹, 黄佳³, 冯程¹, 胡红星^4,*

1.深圳市第三人民医院（南方科技大学第二附属医院）超声科,广东深圳 518112;
2.广东医科大学,广东湛江 524000;
3.深圳市第三人民医院（南方科技大学第二附属医院）重症医学科,广东深圳 518112;
4.深圳市第三人民医院（南方科技大学第二附属医院）器官移植科,广东深圳 518112

通讯作者: * 胡红星,博士,主任医师,Email：553253641@qq.com
基金资助:
深圳市科创委项目（JCYJ20170307095236069）

Comparison of the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in active bleeding after liver transplantation

ZHAO Ning-bo¹, HUANG Xiu-ling², ZHANG Yu¹, ZHOU Dan¹, LI Yi-jun¹, DENG Fen¹, HUANG Jia³, FENG Cheng¹, HU Hong-xing⁴

1. Department of Ultrasound, Shenzhen Third People's Hospital, Shenzhen 518112;
2. Guangdong Medical University, Zhanjiang, Guangdong 524000;
3. Intensive Care Unit, Shenzhen Third People's Hospital, Shenzhen 518112;
4. Department of Organ Transplantation, Shenzhen Third People's Hospital, Shenzhen 518112, China

Received:2021-09-15 Online:2021-12-20 Published:2022-01-19
Contact: HU Hong-xing, 553253641@qq.com

摘要/Abstract

摘要： 目的探讨常规超声和超声造影在肝移植术后活动性出血的诊断价值。方法对2019年4月至2021年7月发生肝移植术后活动性出血33例患者的常规超声和超声造影图像进行分析。以手术探查或腔镜手术为“金标准”。结果常规超声及超声造影对肝移植术后活动性出血的诊断准确率分别为27.3%（9/33）、96.9%（32/33）,差异有统计学意义（χ²=31.165,P<0.05）,出血点位置的诊断准确率分别为27.3%（9/33）、87.8%（29/33）,差异有统计学意义（χ²=22.393,P<0.05）。结论超声造影较常规超声不仅能准确地诊断肝移植术后活动性出血,还能明确出血点位置,对出血点位置明确的患者可在超声引导下行微创止血。

关键词: 超声造影, 肝移植, 活动性出血

Abstract: Objective To investigate the diagnostic value of routine ultrasound and contrast-enhanced ultrasound in active bleeding after liver transplantation. Methods Routine ultrasound and contrast-enhanced ultrasound images of 33 patients with active bleeding after liver transplantation from April 2019 to July 2021 were analyzed. Surgical exploration or endoscopic surgery is the “gold standard”. Results The accuracy of routine ultrasound and contrast-enhanced ultrasound in the diagnosis of active bleeding after liver transplantation were 27.3% （9/33） and 96.9% （32/33）, respectively. The difference was statistically significant （χ2=31.165,P< 0.05）, and the accuracy of bleeding point location was 27.3% （9/33） and 87.8% （29/33）, respectively （χ2=22.393, P< 0.05）. Conclusion Contrast-enhanced ultrasonography is more accurate than conventional ultrasound in diagnosing active bleeding during perioperative period of liver transplantation, which provides an important basis for clinical diagnosis and treatment.

Key words: contrast-enhanced ultrasound, liver transplantation, active bleeding

中图分类号:

R657.3

赵宁波, 黄秀玲, 张瑜, 周丹, 李一君, 邓芬, 黄佳, 冯程, 胡红星. 常规超声和超声造影在肝移植术后活动性出血的诊断价值对比[J]. 岭南现代临床外科, 2021, 21(06): 620-624.

ZHAO Ning-bo, HUANG Xiu-ling, ZHANG Yu, ZHOU Dan, LI Yi-jun, DENG Fen, HUANG Jia, FENG Cheng, HU Hong-xing. Comparison of the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in active bleeding after liver transplantation[J]. Lingnan Modern Clinics In Surgery, 2021, 21(06): 620-624.

参考文献

[1] Zamper RPC, Amorim TC, Queiroz VNF, et al.Association between viscoelastic tests-guided therapy with synthetic factor concentrates and allogenic blood transfusion in liver transplantation: a before-after study[J]. BMC anesthesiology,2018,18(1): 198.
[2] Kummer T, Oh L, Phelan MB, et al.Emergency and critical care applications for contrast-enhanced ultrasound[J]. Am J Emerg Med, 2018, 36(7):1287-1294.
[3] 王婷,唐毅. CEUS儿科应用现状[J].中国医学影像技术,2019,35(5):786-789.
[4] 何颖倩,杨亚汝,张会萍,等. CEUS诊断及动态随访经皮肾穿刺后活动性出血[J].中国医学影像技术,2016,32(3):421-424.
[5] Dötsch TM, Dirkmann D, Bezinover D, et al.Assessment of standard laboratory tests and rotational thromboelastometry for the prediction of postoperative bleeding in liver transplantation[J]. Br J Anaesth, 2017, 119(3):402-410.
[6] Schrem H, Klussmann A, Focken M, et al.Post-operative hemorrhage after liver transplantation: risk factors and long-term outcome[J]. Ann Transplant, 2016, 21:46-55.
[7] 李霄,陶开山.中国肝移植术后并发症诊疗规范(2019版)[J].中华移植杂志(电子版),2019,13(4):269-272.
[8] 井庆红,戴维德,张瑶,王丽萍. 彩色多普勒超声在判断经皮肝穿刺活检术后出血中的应用[J]. 中国医刊,2009,44(12):23-24.
[9] 杜燕,李书兵.超声在腹腔实质脏器闭合性损伤中的诊治价值[J].临床超声医学杂志,2017,19(11):770-772.
[10] 蔡煌兴,向华.创伤性脾出血介入治疗专家共识[J].介入放射学杂志,2020,29(7):641-649.
[11] 刘宁,洪玉才,章仲恒. 超声造影在急危重症中的应用[J].中华诊断学电子杂志,2018,6(2):80-83.
[12] Durkin N, Deganello A, Sellars WE, et al.Post-traumatic liver and splenic pseudoaneurysms in children:diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS)[J]. J Pediatr Surg, 2016, 51(2):289-292.
[13] 宋宏萍,周晓东,任小龙,等. 超声造影鉴别单纯肝血肿与肝血肿伴活动性出血实验研究[J].生物医学工程与临床,2011,15(2):116-120+88.
[14] 李锐,陈卉品,王菲,等. 超声造影联合经皮射频消融在肝癌破裂出血治疗中的应用[J].中国老年学杂志,2020,40(17):3653-3656.
[15] 全军超声医学专业委员会, 中国医学装备协会应急救治装备分会. 战术战伤救治中的超声技术应用专家共识[J].中华医学超声杂志(电子版),2019,16(12):892-898.

常规超声和超声造影在肝移植术后活动性出血的诊断价值对比

Comparison of the diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in active bleeding after liver transplantation

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 13

编辑推荐

Metrics

[1]	刘钊远, 蒋小峰, 薛平. 胆管癌的光动力治疗[J]. 岭南现代临床外科, 2021, 21(05): 495-499.
[2]	鲁旭, 李华, 易述红, 赵辉, 朱曙光, 李海波, 杨扬, 汪国营. 介入联合仑伐替尼桥接治疗超米兰标准肝癌肝移植2例报道[J]. 岭南现代临床外科, 2021, 21(05): 507-511.
[3]	李雄, 蓝思荣, 李嘉, 许建辉. 超声造影对肝脏占位性病变的诊断价值[J]. 岭南现代临床外科, 2020, 20(02): 176-179.
[4]	王泽亮, 胡泽民, 何泳铸, 叶少炜. 影响肝移植术后早期移植物功能障碍的危险因素分析[J]. 岭南现代临床外科, 2020, 20(02): 180-183.
[5]	钟思权，陈伟强. 肝移植术后感染的流行病学特征及危险因素[J]. 岭南现代临床外科, 2020, 20(01): 108-112.
[6]	陈敏强，李文韬，陈念平*. 非侵入吲哚菁绿试验在肝脏外科的临床应用[J]. 岭南现代临床外科, 2019, 19(06): 771-775.
[7]	关智芬，陈伟强*. 肝移植术后复发性肝细胞癌的多学科治疗[J]. 岭南现代临床外科, 2018, 18(05): 589-592.
[8]	卢杰任慧青. 肝癌的多模式治疗[J]. 岭南现代临床外科, 2017, 17(06): 747-750.
[9]	曾庆兵龚懿周芳陈茂根王培伟陈柳云. 常温机械灌注在无缺血肝移植中的应用体会[J]. 岭南现代临床外科, 2017, 17(05): 535-538.
[10]	严燕琼谢晓燕郑荣琴李安华罗葆明. 超声造影对非肝细胞癌肝脏局灶性病变的诊断价值[J]. 岭南现代临床外科, 2014, 14(04): 353-357.
[11]	潘景升秦威邓宝雯马健鸿王浩虎. 超声造影结合粗针活检诊断甲状腺结节的临床应用价值[J]. 岭南现代临床外科, 2013, 13(05): 424-426.
[12]	欧冰智慧肖晓云罗葆明. 声辐射力脉冲成像与超声造影对乳腺肿物诊断价值的比较[J]. 岭南现代临床外科, 2013, 13(05): 383-386.
[13]	肖晓云智慧杨海云赵新保罗葆明. 超声造影及弹性成像在浅表淋巴结鉴别诊断中的应用[J]. 岭南现代临床外科, 2013, 13(01): 49-51.