TIPS术治疗门静脉高压症的进展与展望

Progress and prospect of TIPS for portal hypertension

经颈静脉肝内门体分流术治疗肝硬化门静脉高压已经有30多年的历史,随着支架技术及临床实践技术的发展,经颈静脉肝内门体分流术治疗门静脉高压症技术日臻完善。从过去单一使用裸支架到裸支架联合覆膜支架应用或专用Viatorr支架术式,支架通畅性得到了显著提高。此外通过支架口径的选择、分流道穿刺部分的选择等,逐渐减少了因为分流过大引起的肝性脑病、肝功能衰竭等并发症的发生。经颈静脉肝内门体分流术技术具有微创、安全、降低门静脉压力的确切优点,在治疗门静脉高压症食管胃静脉曲张出血、顽固性腹水等方面逐渐成为主要的手术方式之一。

Transjugular intrahepatic portosystemic shunt(TIPS)has been used in the treatment of cirrhotic portal hypertension for more than 30 years.With the development of stent technology and clinical practice technology,TIPS is becoming more and more perfect in the treatment of portal hypertension.From the single-use of bare stent in the past to the application of bare stent combined with coated stent or particular Viatorr stent,the patency of stent has been significantly improved.In addition,the selection of stent caliber and the puncture part of shunt gradually reduces the occurrence of hepatic encephalopathy,liver failure and other complications caused by excessive shunt.TIPS technology has the advantages of minimally invasive,safe and reducing portal vein pressure.It has gradually become one of the primary surgical methods in the treatment of portal hypertension,esophagogastric variceal bleeding,intractable ascites,and so on.