直接腔静脉途径建立肝内门腔分流的适应证与临床结果  

Transjugular Intrahepatic Portosystemic Shunt by Direct Transcaval Approach: Indications and Clinical Results

作　　者：褚建国[1] 孙晓丽[1] 朴龙松[1] 黄鹤[1] 陈肇一[1] 徐晓明[1] 吕春燕[1] 孙鹏[1] 

机构地区：[1]中国人民解放军空军总医院放射科,北京100036

出　　处：《临床放射学杂志》2004年第11期992-995,共4页Journal of Clinical Radiology

摘　　要：目的　评估在肝静脉与门静脉间解剖异常时 ,经肝段下腔静脉直接穿刺门静脉分支完成肝内门腔静脉分流术 (TIPS)操作的可行性和安全性 ,探讨其临床意义。资料与方法　 6 5例肝硬化门静脉高压患者行经肝段下腔静脉直接穿刺门静脉完成TIPS。结果　 6 5例经肝段下腔静脉TIPS均获成功 ,技术成功率 10 0 % ,未出现与术中技术相关并发症 ,1年内再狭窄率明显低于常规TIPS ,3例肝性脑病需限流支架置入得以控制。结论　经肝段下腔静脉TIPS技术用于肝静脉与门静脉间解剖异常病例是安全、有效的 ,同时由于肝内分流道曲度较小 。Objective To estimate the feasibility and security of transjugular intrahepatic portosystemic shunt by direct transcaval approach in patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins. The clinical significance will be discussed.Materials and Methods Transjugular intrahepatic portosystemic shunt by direct transcaval approach was underwent in 65 cirrhotic patients with portal hypertension.Results Technical and functional success was achieved in all patients without complications. The rate of restricture was markedly less than that with conventional TIPS in one year, 3 hepatic encephalopathy cases need stent threapy. Conclusion Patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins, transcaval TIPS creation is secure and feasible, the rate of stent reopen is increased obviously in one year.

关 键 词：下腔静脉 门脉高压 门体分流 肝脏介入治疗 

分 类 号：R657.3[医药卫生—外科学]