摘要
本文报告了采用经颈静脉肝内门腔静脉内支架分流术（ＴＩＰＳＳ）和ＴＩＰＳＳ并用食管胃底静脉硬化栓塞术ＳＥＥＶ或称门静脉断流术两种方法，治疗８４例门静脉高压症的临床结果。８２例获得成功（成功率９７．６％）。其中，３４例仅采用ＴＩＰＳＳ方法；４８例采用ＴＩＰＳＳ并用ＳＥＥＶ方法。７１例为择期治疗，另１１例为急诊ＴＩＰＳＳ。肝内分流通道直径分别为８～１０ｍｍ（６９例）和１２ｍｍ（１３例）；术后门静脉压力平均下降１３．０±５．４ｃｍＨ２Ｏ。术后平均随访时间为９．５个月（１～３０个月）。术后７例有再出血发生（８．５％），其中，ＴＩＰＳＳ组６例（２４％）；ＴＩＰＳＳ并用ＳＥＥＶ组且例（２．６％）；１１例出现肝性脑病（１３．４％），其余病例均良好。
Results of 84 cases of portal hypertension treated with trans jugular Intrahepatic portal -systemic Stent Shunt (TIPSS)and partial TIPSS with Sclerotic Em bolization of Esophagogastric Varices (SEEV) namely blockage of poratl lateralic were reported. The procedure was succesed in 82 cases of 84 cases (97. 6%). Among them. 34 cases were treated with TIPSS only, 48 Cases with TIPSS+SEEV. 71 cases were treated at selected time and 11 cases at emergency. In 69 Cases diameter of shunt was 8～10mm, 12mm in 13 cases; portal pressure dropped mean 13. 5±5. 4cmH2O after procedure. The mean clinical follow-up period was 9. 5 months (1～30 months). Rebleeding ocurred in 7 cases (8. 5 %) .6 cases in TIPSS group (24%). 1 in TIPSS+SEEV group (2. 6%); Hepatic encephalopathy ocurred in 11 cases (13. 4%). All the remaining cases are weil.The authors think that (1) TIPSS is a less invasive, effective nonsurgical therapeutic method of portal hypertension with less complication and wider indication. (2) Partial TIPSS with SEEV can raise clinical effect of TIPSS markedly.
