经颈静脉肝内门体支架分流术的并发症及其防治

目的探讨经颈静脉肝内门体支架分流术（ｔｒａｎｓｊｕｇｕｌａｒｉｎｔｒａｈｅｐａｔｉｃｐｏｒｔｏｓｙｓｔｅｍｉｃｓｔｅｎｔ－ｓｈｕｎｔ，ＴＩＰＳＳ）的并发症及其防治。方法分析３１例行ＴＩＰＳＳ术患者的情况。结果手术成功率９６７％，术后近期并发症有转氨酶升高（１００％）、术后炎性反应（３２２％）、胆道出血（６４％）、术后死亡（６４％）、腹膜炎（３２％）。术后远期并发症有胆红素升高（５４８％）、白蛋白下降（２９０％）、支架狭窄或阻塞（１９３％）、低蛋白水肿（１６１％）、肝性脑病（１６１％）、合并肝癌（６４％）。结论ＴＩＰＳＳ术应严格掌握适应证并应严密注意术后并发症的防治。

PREVENTION AND TREATMENT OF COMPLICATIONS IN TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC STENT-SHUNT

Objective To study the prevention and treatment of the complications in transjugular intrahepatic portosystemic stent-shunt (TIPSS). Methods Analysis of the conditions of thirty-one patients undergoing TIPSS treatment. Results The operation success rate was 96 7%, the complications in the near future after operation were elevated serum transaminase (100%), inflammatory reactions (32 2%), bile duct bleeding (6 4%), mortality rate (6 4%), and peritonitis (3 2%). The post operative complications after one month were ele atedevevated serum bilirubin (54 8%), reduced albumin (29 0%), stent stenosis or occlusion (19 3%), hypoalbumin edema (16 1%), hepatic encephalopathy (16 1%), and associated liver cancer (6 4%). Conclusion It is concluded that more strict indication for TIPSS and paying more attention to prevente and treat the complications after operation are recommended.