经颈静脉途径介入治疗门静脉血栓  

Interventional therapy via jugular vein access for the treatment of portal thrombosis

作　　者：贺辰龙[1] 崔进国[2] 苏秀琴[3] 吕伟[4] 

机构地区：[1]石家庄市(铁路)中心医院放射科,050000 [2]解放军白求恩国际和平医院放射科 [3]山西医科大学第二医院放射科 [4]河北医科大学第二医院一日病房

出　　处：《介入放射学杂志》2009年第2期87-89,共3页Journal of Interventional Radiology

摘　　要：目的评价经颈静脉途径治疗门静脉血栓的疗效。方法经颈静脉途径治疗21例门静脉血栓患者,包括门静脉内置管药物溶栓和(或)机械性碎栓抽吸清除血栓,对残存狭窄进行球囊扩张并植入内支架。对于合并肝硬化上消化道出血者血栓清除后建立肝内门体分流道。结果18例患者门静脉得到开通,患者消化道出血、腹水及腹痛、腹胀等症状消失,2例建立了门体分流道的患者术后发生肝性脑病,经药物治疗得到控制。治疗失败的3例患者,其中1例住院期间因消化道出血死亡,另2例给予药物治疗。结论经颈静脉途径介入治疗门静脉血栓是安全、微创、有效的方法。Objective To assess the efficacy of the interventional therapy using transjugular pathway in the treatment of portal thrombosis. Methods Twenty-one patients with portal thrombosis were treated with interventional management via jugular vein access. The procedures included pharmaceutical thrombolysis through portal indwelling catheter and/or mechanical thrombectomy（MT）, while balloon angioplasty and stent placement were used to treat the residual strictures. For patients complicated with cirrhosis and hemorrhage of the upper digestive tract intrahepatie portosystemie shunt was established after MT. Results Portal patency was obtained in 18 patients with disappearance of the symptoms of gastrointestinal bleeding, ascites, as well as abdominal pain and distention. In two patients receiving the procedure of intrahepatic portosystemic shunt hepatic encephalopathy developed, which was controlled by medication. Of three patients with therapeutic failure, one died of gastrointestinal bleeding and two received medication. Conclusion Interventional therapy via jugular vein access is a safe, minimally-invasive and effective treatment for portal thrombosis. （J Intervent Radiol, 2009, 18： 87-89）

关 键 词：门静脉 血栓 溶栓 介入治疗 

分 类 号：R575[医药卫生—消化系统]