经颈内静脉肝内门体分流术治疗肝硬化食道静脉曲张出血的研究

Study of transjugular intrahepatic portosystemic shunt(TIPS) in esophageal varix with hepatic cirrhosis

目的探讨经颈内静脉肝内门体分流术(TIPS)对肝硬化食道静脉曲张出血患者的疗效以及术后并发症发生的原因及处理方法。方法对2003年5月至2008年5月45例肝硬化食道静脉曲张出血患者病情稳定后进行择期TIPS手术,于左肝静脉与门静脉主干之间分别置入100mm×10mm或100mm×8mm金属支架,对胃冠状静脉采取弹簧圈栓塞,术后观察患者食道胃底静脉曲张程度。结果本组45例肝硬化食管胃底静脉曲张的治愈率为86.7%,好转率为13.3%,有效率为100%。结论TIPS联合胃冠状静脉栓塞作为一种新的对肝硬化食管胃底静脉曲张的治疗方法,安全性高,并发症少,复发率低,疗效确切。

Objective To discuss the effect of transjugular intrahepatic portosystemic shunt（TIPS） in esophageal varix with hepatic cirrhosis, the causes and management of the postoperative complications. Methods TIPS was performed on 45 patients with esophageal varix with hepatic cirrhosis after stable bleeding from May 2003 to May 2008. Metal stents, 100mm×10mm or 100min×8mm, were placed between left hepatic -vein and portal vein,and vena coronaria ventriculi was embolized by circlip ring. The degrees of the various veins were observed after operation. Results The recovery rate,improvement rate and the effect rate were 86.7 %, 13.3% and 100% respectively. Conclusion TIPS combined with vena coronaria venous embolism,a new method in esophageal varix with hepatic cirrhosis,has such fortes as high safety,little complications,low recurrence rate and certain therapeutic effects.