经导管溶栓治疗门静脉血栓

Transcatheter Dissolution of Portal Vein Thombosis

目的:对临床上采用两种途径置管溶栓治疗门静脉血栓的病例进行回顾性研究,并对比此两种方法的优缺点。材料方法:病例19人,男性11人,女性8人,年龄21-63岁,平均49.7岁。采用经皮经肝途径10人,颈内静脉途径9人,分别对两种方法的疗效、并发症进行随访。疗效分为三等:A,血栓大部分消除,症状消失;B,血栓消除不明显,但侧枝循环建立丰富,症状缓解;C,血栓未消除,症状未缓解。结果:采用经皮肝穿途径,技术成功率达100%,有效率达82%,严重并发症的发生率30%(3/10);采用TIPSS途径,技术成功率66.7%,有效率86.7%(5/6),严重并发症发生率11.1%(1/9)。结论:经皮肝穿途径和经TIPSS途径穿刺门静脉并置管进行溶栓治疗,疗效良好,但必须严格规范操作及加强术后观察护理以防治相应的并发症。

Objective： To retrospectively analysis 19 cases with portal vein thrombosis （PVT） treated by transcatheter dissolution （transjugular method and transhepatic method）. The advantages and disadvantages of these two methods were compared. Material and methods： 19 male and 8 female were included in this study. There ages ranged between 21-63 years old with the average age being 49.7. The portal vein was approached via transhepatic method （TH） in 10 cases while via transjugular method （TJ） in 9 cases. The effects and complications were followed up. The effects were categoried into 3 grades： A, most of the thrombus dissolved and the patients were free of symptoms; B, the thrombus remained but the collaterals enriched and the symptoms relieved markedly; C, no obvious effect was observed. Results： In the TH cases, the technical success rate was 100% and efficiency rate was 82%. Major complications were found in 30% cases; In TJ cases, the technical success rate, efficiency rate and major complication rate were 66.7%, 86.7% and 11. l% respectively. Conclusion： The transeatheter dissolution of PT via TH and TJ methods have good effects but they must be performed and followed carefully to prevent and treat the major complications.