可扩张内支撑建立肝内门体分流的实验和临床研究

作者采用自制的新型可扩张性内支撑对１０只正常犬和１４０例晚期肝硬变门静脉高压症患者建立肝内门体分流。正常犬分流道建立８周内全部阻塞，为支撑内肝组织生长、纤维组织和内皮细胞增生所致。门静脉高压症患者分流道建立后１￣２４月，分流道狭窄或阻塞率为１２．０％，多发生于术后１年内，与分流道内膜过度增生有关。可扩张性内支撑对维持肝内分流道的通畅有着极为重要的作用；同时，门体静脉压力梯度、支撑内血流速度、内支撑

Experimental and clinical study of intrahepatic portosystemic shunt: use of expandable stents

Intrahepatic portosystemic shunt with self-made expandable stems was performed in ten normal dogs and 140 cases of advanced liver cirrhosis with portal hypertension.The occlusion of shunts in dogs occurred with in 8 weeks after TIPS and was due to the ingrowth of liver parenchyma and abundant proliferation of intima and connective tissue indide stent lumen. At follow-up of 1-24 months,the stenosis and occlusion of shunt occurred in 12% of cases with portal hypertension during one year after TIPS and were mainly due to the proliferation of intima of shunt. Therefore,the expandable stent greatly contributes to the patency of intrahepatic portosystemic shunt. Meanwhile the pressure gradfient of portosystem,the blood velocity in stems,the proper placement of stems and the overproliferation of intima have the deep effect on the patency of intrahepatic portsystemic shunt.