摘要
目的：了解并探讨经颈静脉肝内门腔静脉内支架分流术（ＴＩＰＳＳ）后分流道狭窄或闭塞的发生情况及介入治疗的效果。材料和方法：对２９例ＴＩＰＳＳ术后的患者进行了血管造影检查，其中常规复查１８次，术后再发出血或腹水者１３次。同时，对２１例分流道不畅者均进行了再开通术治疗。结果：血管造影显示分流道通畅者８例，狭窄或闭塞者分别为１７和４例。分流道再开通治疗均获成功。活动出血停止，门脉压力由４．５±１．１ｋＰａ（１ｋＰａ＝１０．２ｃｍＨ２Ｏ）降为３．６±０．８ｋＰａ。在平均１２个月随访期中，有３例因分流道再次不畅而出血。结论：ＴＩＰＳＳ术后行定期造影检查既可及时发现分流道狭窄或闭塞，又可同时行二次介入治疗。
Purpose:Toevaluatetheincidenceofstenosisandocclusiondevelopingaftertran-sjugularintrahepaticportosystemicstentshunt(TIPSS)andtheefectofthesecondaryintervention.Materialsandmethods:Thirty-oneshuntvenogramswereobtainedin29patientsduetorebleedingorasregularpostoperativefolowupangiography.Theshuntabnormalitiesin21patientsweretreat-edwithrecanalization,baloondilationand/oradditionalstentplacement.Results:Twenty-oneshuntabnormalitieswerefoundin29patientswhoreceivedthefirstexaminationafterTIPSS,where-astheother8patientshadwelfunctioningshunts.Shuntstenosiswasshownin17patientsandoc-clusionin4patients.Aftersuccessfultreatment,theactivebleedingstoppedandthemeanportalpressuredropedfrom4.5±1.1kPato3.6±0.8kPa.Duringamean12monthfolow-upperiodaftertherevision,3patientsoccurredrebleedingduetorecurringshuntabnormality.Conclusion:TheshuntrestenosisandocclusionafterTIPSSisnotinfrequent.Regularangiographycandemonstratetheshuntabnormalities.Thesecondinterventionisnecessaryandefectiveinthetreatmentofsteno-sisorocclusiontherebypromotingthemiddleandlong-termefectofTIPSS.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1996年第7期452-455,共4页
Chinese Journal of Radiology
基金
卫生部科研课题基金
关键词
门腔静脉分流
血管疾病
介入疗法
PortocavalshuntVasculardiseasesRadiology,interventional
