TIPSS后分流道狭窄的介入性组织活检与病理学研究

Study of Interventional Biopsy and Histopathology on Stenosis of Shunt Tract after TIPSS

目的:了解介入性活检技术的可行性及分流道狭窄的组织构成,探讨分流道狭窄的形成机制。材料与方法:10例分流道狭窄或闭塞者,采用心肌活检钳和Simposon旋切导管经颈静脉途径对狭窄组织进行了活检,其中8例采用活检钳法,2例采用导管旋切法。所取病理标本行常规HE染色及免疫组化染色检查。结果:10例病人的介入活检操作全部成功,无并发症发生。光镜下狭窄组织主要为纤维结缔组织和不同机化阶段的血栓,并有大量泡沫细胞及炎性细胞。结论:1.介入性活检技术是安全而有效的活检方法;2.分流道内的狭窄与血栓的形成和机化有关。

Purpose: To evaluate the feasibility of interventional biopsy, the component of stenotic tissues of shunt tract and mechanism of shunt stenosis. Materials and Methods: The pathologic specimens of stenotis shunt tract were obtained in 10 patients with catherization endovascular biopsy clamp and atherectomy methods, then they were undergone routinely with HE stain and immunocytochemical stain, and observed procedures under microscope. Rusults: all of interventional biopsy were succeeded without complication. The microscopies, findcarge of stenotic tissue were primarily composed of fibrotic granulations and thrombi with inflammatory cells and exuberant foam cells derived from endothelial cells, smooth muscle cells and rhagiocrine cells. Conclusion: 1)The interventional biopsy is a safe and effective method. 2)The stenosis in parenchymal tract is related to thrombosis and tissue orangnization.