肝前性门脉高压的临床特点及腔内治疗

Clinical features and endovascular treatment of prehepatic portal hypertension

目的探讨肝前性门脉高压的临床特点及其腔内治疗效果。方法回顾性分析该院2007年8月至2013年6月收治的7例肝前性门静脉高压患者,均经临床检查及CT检查确诊肝前性门静脉高压,并行经皮经肝或经皮经脾穿刺门静脉并成功置入覆膜支架,必要时栓塞胃底食管曲张静脉。结果 5例患者采用经皮经肝途径,2例患者采用经皮经脾途径。介入治疗术后停止出血,患者出现轻微腹痛、发热、恶心、呕吐,对症处理后1周内缓解。7例患者门静脉内均成功置入支架。术后平均住院时间9.6 d。结论经皮经肝或经皮经脾门静脉覆膜支架成形术治疗肝前性门静脉高压安全可行,能有效控制门静脉高压的症状。

Objective To investigate the clinical features and endovascular treatment effect of prehepatic portal hypertension. Methods Seven cases of prehepatic portal hypertension in our hospital from August 2007 to June 2013 were retrospec- tively analyzed, all cases were definitely diagnosed as prehepatic portal hypertension by clinical examination and CT, and successfully placed endovascular covered stent and gastro-esophageal varices embolization by percutaneous transhepatic or percuta- neous transsplenic portal vein puncture,and conducted the gastric esophageal varicose vein embolism in necessity. Results Five cases adopted percutaneous transhepatic approach and 2 cases adopted percutaneous transsplenic approach. Hemorrhage was stopped after interventional therapy, the patients appeared slightly abdominal pain, fever, nausea and vomiting,which were re- lieved within 1 week after symptomatic treatment. Seven cases were successfully implanted stents in the portal vein. The mean postoperative hospitalization duration was 9.6 d. Conclusion Percutaneous transhepatic or percutaneous transsplenic portal vein covered stent angioplasty is safe and feasible for treating prehepatic portal hypertension and can effectively control the symptoms of portal hypertension.