摘要
102例经颈静脉途径肝内门体分流术(TIPSS)的应用结果,主要探讨操作技术问题和影响食管静脉曲张出血疗效的因素。结果:92例成功,8例失败,成功率为92.2%。分流后,门脉压从术前3.97±0.44kPa降至2.30±0.34kPa。Doppler超声显示:门脉主干血流速度,从术前14.0±4.5cm/s增至46.5±14.5cm/s。81例随访3~18个月(平均8.5个月).分流道狭窄6例、阻塞3例,再通成功5例。随访病例的首次通畅率为88.9%,第二次处理后的通畅率为95.1%。结论:TIPSS创伤性较小,降低门脉压可靠,是治疗门脉高压症的优良方法,其远期疗效有待进一步观察。
The authors retrospectively analyzed 102 cases of TIPSS focusing onthe
technique,the effectiveness and factors affecting the procedure,All patients hadobvious
gastroeseophageal varices,among them 88 had recurrent bleeding.The shuntswere
successfully constructed in 94 patients without death attributable to theprocedure. Portal
pressure was reduced from 3.97±0.44kPa to 2.30±0.34kPa aftershunting. Doppler
ultrasonography revealed the maximum blood flow velocity in themain portal trunk increased
from 14.o±4.5cm/sec to 46.5±14.5/sec. 8l patients werefollowed-up,the mean follow-up period
in the successful cases was 8.5 months(range3~18 months).Stenosis and occlusion were
found in 9 patients,6 of them hadrecurrence of bleeding,and 5 of them were retreated
successfully with dilatation andreplacement by a stent.The patency of shunt was deterlnined by
color Dopplerultrasonography in the remaining cases who had no rebleeding.The overall
primarypatency was 88.9%,angioplasty and stent placement in the stenotic shunt resulted in
asecondary patency of 95.1%,The results suggest that TIPSS is relatively safe andeffective for
lowering the portal pressure and controlling the variceal bleeding,andlong term effects would
await further investigation.
出处
《中华消化杂志》
CAS
CSCD
北大核心
1996年第3期128-131,共4页
Chinese Journal of Digestion
关键词
门脉高压
门体分流术
肝脏
介入放射学
Portal hypertension Portosystemic shunts Hepatic
Inter-ventional procedure.