介入性腹腔腔静脉分流术治疗顽固性腹水

目的：评价介入性腹腔腔静脉分流术对终末期肝功能失代偿患者并发顽固性腹水的治疗效果。材料与方法：７例转流患者年龄２２～７０岁，平均４８．１岁。选择两端多侧孔分流导管，在腹腔与上腔静脉之间建立转流，术中测定腹腔内压和上腔静脉压，术后记录腹围改变，监测其肝肾功能指标。结果：腹腔腔静脉压力差均值为１２２．９ｍｍＨ２Ｏ，腹围平均缩小１１．４ｃｍ（７～１５ｃｍ）；术后肝肾功能指标得到改善，其中５例临床症状明显缓解。结论：介入性腹腔腔静脉分流术具有操作简便和少创性特点，对于改善终末期肝功能失代偿合并大量腹水患者的生活质量具有确切疗效

Interventional Peritoneo Venous Shunting for Intractable Ascites

Objective: To evaluate the therapeutic efficacy of patients with terminal phase of liver failure and intractable ascites, administered by interventional peritoneo venous ascites shunting (IPVS). Materials and Methods:The group of 7 patients ranged in age of 22 to 70 yrs (mean 48.1 ), including 5 cases of hepatocellular carcinoma with serious cirrhosis, and 2 of portal cirrhosis. Procedure of IPVS includes implanting percutaneously shunt catheter, designed to double tips with multiple holes, between peritonieal cavity and superior vena cava (SVC), measuring intra abdominal pressure and SVC pressure intraoperatively. Variations of abdominal girth, liver and renal function were recorded in postprocedure.Results:The mean difference of pressure between abdominal cavity and SVC was 122.9mmH 2O;The mean value decrement of abdominal girth was 11.4cm(7 to 15cm); As following up of 8 days to 6 months post procedure, the content of serum total protein and albumin slightly raised, and decreased of blood urea nitrogen. The clinical symptoms in 5 patients remitted evidently.Conclusion: IPVS has the characteristics of simple manipulation and less invasion, and exact therapeutic effects to improve living quality of patients with terminal phase of liver failure and intractable ascites.