经颈静脉肝内门腔静脉内支架分流术治疗门脉高压症

Role of Transjugular Intrahepatic portosystemic stent shunt in patient with portal Hypertention

本文采用经颈静脉肝内门腔静脉内支架分流术(TIPSS)治疗8例反复食管胃底静脉曲张出血的肝硬变门脉高压症(CPH),术中使用8～10mm金属内支架在门静脉和肝静脉之间形成人工通道,达到降低门脉压力、防止上消化道再出血、缩小脾脏、减少腹水的目的。TIPSS术后,症状均得到有效的控制或明显改善。笔者认为:TIPSS是一种有效而可靠的降低门脉压力的非手术疗法,具有疗效确切,创伤性小等优点,因此,应成为治疗CPH消化道大出血的首选方法、同时对Child分级较好的中早期CPH患者也可以起到预防出血的作用。

Transjugular intrahepatic portosystemic stent shunt (TIPSS) was used in 8 cases for reatment of liver cirrhosis with hypertention. All cases had severe gastroesophageal varices and two patients had recurrent hemorrhage for 2-6 times before TIPSS. Eight-ten mm dia-meterspiral gianturco Z-stent and strecker stent was put between the portal and hepatic venous systems. The average pressure of portal vein were dropped from 4.24 ± 0.43 kPa to 1.46 ± 0.17 kPa,Gastrointestinal bleeding were controlled effectively after TIPSS. The authcrs consider that TIPSS creation is an effective and reliable nonsurgeric means of lowering portal pressure. The major advantages of the procedure include speed, safety. low morbidity or complicntion and wide application.