提高Tipss手术成功率相关因素的探讨

报告42例Tipss手术，38例首次成功，1例第一次手术成功，1例未成功，12例行食管胃痛曲张静脉栓塞．笔者认为，择期Tipss手术者术前应作必要的检查和难备，掌握适应症；术中在事先复习影像学资料，了解肝——门静脉及二者解剖关系后，应在B超和透视联合导向下行肝静脉和门静脉穿刺，控制门体静脉压差，必要时行栓塞治疗；术后应观察病人病情变化，加强护理，合理用药，预防或控制并发症的发生，定期B超复查分流通道情况，便于及时处理。这样，可望提高Tipss手术成功率。

Study of the Correlative Factors to Improve the Succession Rate of Tipss Operation

42 Cases of Tipss operation, among them 40 cases were successsful with one operation, 1 case with twice operations, 1 case failure, were reported. In addition, embolization of esophago cardiac varices in 12 cases, emergency treatment with Tipss operation. we believed that physician make detailed medical examination be fore Tipss operation in order to decide medical indecations, also do some necessary works for preparation, such as reviewing imaging date, understanding the runs of hepatic vein and protal vein and the anatomical relationship between them before operation, combined use of ultrasound and fluoroscopy for the puncture of the portal vein.Controlling the presture difference between the systemic vein Bnd portal vein and making the embolic therapy. It necessary was very importand. After operation, it is essential to carefully observe the changes of patients clinical condition, strenthen the intensive nursing, rationally use the medicne for the patients, prevent or control the occurence of complications, and make ultrasound gUided shunting channel at regular mternals. So it is hopeful to improve the succession rate of Tipss operation.