双导丝一步穿刺法及经皮肝穿刺门静脉造影在TIPS中的应用

目的探讨双导丝一步穿刺法及经皮肝穿刺门静脉造影在TIPS中的操作方法及应用价值。方法采用双导丝一步穿刺法及经皮肝穿刺门静脉造影法,对21例肝硬化并食管胃底静脉曲张破裂出血患者行TIPS术。结果 21例患者均成功实施TIPS手术,手术时间(152.41±50.38)min,手术穿刺针数(2.50±1.54)针,结果显示改良TIPS术可显著降低门静脉压力,改善肝功能,手术成功率100%,病死率5%。结论采用双导丝一步穿刺法及经皮肝穿刺门静脉造影的方法行TIPS术,能降低手术难度,值得临床推广应用。

The application of dual-wire one-step puncture and percutaneous portal vein puncture portography in TIPS

Objective To investigate the operational approach and value of dual-wire one-step puncture and percutaneous portal vein puncture portography in transjugular intrahepatic portosystemic shunt (TIPS).Methods Twenty-one cirrhosis patients with gastroesophageal varices bleeding received treatment with TIPS by dual-wire one-step puncture and percutaneous portal vein puncture portography.Results All of these patients were successfully operated on with TIPS, with average operation time of (152.41 ±50.38)min and surgery puncture times of (2.50 ± 1 .54).Meanwhile,TIPS treatment significantly attenuated the portal venous pressure and liver function,with success rate as 100% and mortality as 5%.Conclusion The method of TIPS using dual-wire one-step puncture and percutaneous portal vein puncture portography could reduce operation difficulty,which is worth to be popularized and applied.