浅析经颈静脉肝内门体静脉分流术治疗门静脉高压并发症

目的评估经颈静脉肝内门体静脉分流术(TIPS)治疗肝硬化门静脉高压并发症的安全性和有效性。方法自2013年12月至2014年6月,收集31例接受TIPS治疗的肝硬化门静脉高压症的临床资料。术前均接受肝脏CT增强扫描和血管三维重建,了解肝静脉与门静脉的解剖结构关系,以便确定穿刺门静脉分支的靶点,术中,28例栓塞曲张的食管胃底静脉,28例置入巴德公司的一个裸支架加一个Fluency覆膜支架,2例置入单个Fluency覆膜支架。结果 31例患者中30例TIPS操作成功,其中穿刺门静脉右支26例,穿刺门静脉左支4例,成功率为96.8%(30/31);1例因门静脉海绵样变性未成功;无严重并发症发生,近期止血率为100%。结论 TIPS治疗肝硬化门静脉高压并发症是安全和有效的。

A brief analysis Of transjugular intrahepatic portosystemic shunt in the treatment of Portal hypertension complications of liver cirrhosis

Objective To evaluate the safety and efficacy of modified transj ugular intrahepatic portosystemic shunt（TIPS） in the treatment of portal hypertension of liver cirrhosis. Methods From December 2013 to june 2014,the collected clinical data were from 31 patients with liver cirrhosis who were accompanied with portal hypertension accepted TIPS treatments before operation,a11 the patients received＂Liver enhanced computed tomography（CT） and hepatic blood vessel CT three——dimensional reconstruction to analyze the anatomical relationship of hepatic vein and portal vein and select the puncture location of portal vein branches. During operation,28 patients＇ gastric coronary veins were embolismed,28 patients used one 8mm Bare stent and one 8mm Fluency stent graft and 2patients only implanted one 8mm Fluency stent graft. Resu Its Among 31 patients,TIPS operations of 30 were successfully performed and the success rate was 96. 8%（30 /31）,one case failure because of cavernous transformation of the portal vein,Among 30 cases with successful operation,26 were the right branch of portal Vein puncture and 4 were the 1eft branch puncture. Short——term hemostasis rate was 100%. The incidence rate of Severe complication was nought. Conclusion The TIPS was safe and effective in the treatment of portal hypertension of 1iver cirrhosis and its complication.