经颈内静脉肝内门体分流术治疗门静脉高压症

Preliminary report on portal hypertention treated bytransjugular intrahepatic portosystemic stent shunt

经颈内静脉肝内门体分流术（ｔｒａｎｓｊｕｇｕｌａｒｉｎｔｒａｈｅｐａｔｉｃｐｏｒｔｏｓｙｓｔｅｍｉｃｓｔｅｎｔｓｈｕｎｔ，ＴＩＰＳＳ）是门静脉高压症治疗方法的重大进展一。作用采用该方法对５０例Ｃｈｉｉｄ－ｐｕｇｈ平均评分１０．３３±２．３４的肝硬变门静脉高压症患者进行治疗。５例门静脉血栓除外，ＴＩＰＳＳ成功率是９５．６％，肝内门体分流建立后出血立即停止，门静脉压力下降１．３６±０．４８ｋＰａ，食管曲张静脉和其它侧支血管消失；术后１周脾脏缩小，腹水消退，体重减轻，支撑内血流速度足８５．６１±３５．８３ｃｍ／ｓ；随访１～９个月，无出血、腹水复发。支撑内血流速度是８３．８３±３４．７４ｃｍ／ｓ，术后１个月内死亡３例，死因为肝功能衰竭和复发出血性。轻度肝性脑病６例，本组资料表明：ＴＩＰＳＳ对门静脉高压症食管静脉曲张出血、腹水的近期疗效显著；而且创伤小，并发症少，有进一步推广应用的价值。

Abstract Transjugular intrahepatic portosystemic stentshunt(TIPSS)was carried out in 50 cases of liver cir-rhosis with portal hypertention. An average Child-Pugh score in these cases was 10.33±2.34.Except for5 cases with portal vein occlusion,the technical successrate of in 45 cases was 95.6%. Acute variceal bleedingwas immediatelv controlled.Portal pressure was re-duced by 1.36±0.48kPa,Esophageal varices and as-cites disappeared.The shrink of spleen,the reducingof body weight were also observed in a week followingTIPSS.”The velocitv of blood flow in stents was 85.61±35.83cm/s. Follow-up of 1-9 months found nore-bleeding and ascites. The velocity of blood flow instents was 83.83±34.74cm/s.Three patients died ofliver failure and variceal rebleeding within a month af-ter TIPSS. Slight encephalopathy was observed in 6cases.