无创影像学技术在经颈静脉肝内门—体静脉支架分流术中的作用

THE GUIDANCE OF NON-TRAUMATIC IMAGETECHNIGUE IN TRANSJUGULAR INTRAHEPATICPORTASYSTEMIC STENT SHUNT (TIPS)

本文总结了１７例ＴＩＰＳ手术的经验，探讨ＣＴ结合Ｂ超在ＴＩＰＳ手术中的引导作用。ＣＴ可以在术前规划穿刺深度及方向，改变穿刺针弯曲的角度以适应各个病例肝内血管构型的特点，并使术者对肝内、外血管和肝脏边缘与选定骨注标志的关系有明确的了解。术中Ｂ超可确认门静脉的穿刺部位以及支架安放的位置。这种无创定位方法提高了ＴＩＰＳ手术的可靠性和安全性。本组手术成功率为９４．１％，无一例发生肝被膜下出血或腹腔出血，这说明此种方法是可行的。

7 cases of TIPS guided by CT combined with BUS were reported. The hep-atic vein, Portal vein and their relationship to the liver margin and superficialbone marks were well localized. The direction of intrahepatic puncture and thedepth of the stent could be calculated before hand and could be further guidedduring TIPS procedure by BUS. The rate of success was 95. 1 %.None subcap-sular hematoma of the liver or intra-abdominal hemorrhage occured.