经颈静脉肝内门腔静脉内支架分流术（附22例分析）

Transjugular Intrahepatic Portosystemic Stent Shunt:Preliminary Report of 22 Cases

经颈静脉肝内门－腔静脉内支架分流术（ＴＩＰＳＳ）是用非外科手段治疗肝硬化、门脉高压，胃、食管静脉曲张的新技术，具有创伤小，技术成功率高，并发症少的优点。自１９９３年３月５日以来我们完成了２２例（包括２例急诊ＴＩＰＳＳ），成功率为９５．４５％（２１／２２）。分流道的直径为１０ｍｍ。术后平均门脉压力从术前的４．０４±０．６６ｋＰａ（１ｋＰａ＝１０．２０ｃｍＨ＿２Ｏ）降到２．４４±０．６２ｋＰａ，绝大多数患者腹水吸收，静脉曲张减轻或消失。我们的初步经验：ＴＩＰＳＳ能安全、有效地降低门脉压，控制静脉曲张破裂出血，消除腹水。ＴＩＰＳＳ的长期临床效果有待进一步观察。

Transjugular intrahepatic portosystemic stent shunt(TIPSS)is a new nonopera- tive therapeutic procedure used by interventional radiologist to manage patients with portal hyperten- tion,gastroesophageal variceal hemorrhage,and has the advantages of less invasiveness high success- ful rate and low incidence of complications. Since March 5th.1993,we performed 22 cases of TIPSS(two were emergent TIPSS).The successful rate was 95.45%(21/22).The diameter of the shunt was 10mm. The average portal vein pressure significantly dropped from 4. 04± 0. 66kPa(1kPa= 10.20cmH_2O)to 2.44±0.62kPa,and variceal hemorrhage and ascites were effectively controlled af- ter the procedure. The authers suggested that TIPSS is a safe and effective treatment for portal hy- pertention,ascites and variceal bleeding. The long-term benefit of TIPSS needs further follow-up study.