经皮门静脉入路在门静脉病变介入治疗中的意义  

Accesses of percutaneous portal vein in the interventional therapy for portal vein diseases

作　　者：吴育民[1] 梁惠民[2] 周汝明[1] 邱水波[1] 刘闽华[1] 戴懿 庄少育[1] 

机构地区：[1]深圳市第二人民医院放射科DSA室,广东深圳518035 [2]华中科技大学同济医学院附属协和医院放射科,湖北武汉430022 [3]南方医院放射科,广东广州510515

出　　处：《中国介入影像与治疗学》2010年第6期605-608,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨经皮门静脉入路在门静脉病变介入治疗中的意义。方法回顾性分析87例因门静脉病变接受介入治疗的门静脉插管患者的资料,入路方法包括经门静脉右支属支(48例)、左支属支(26例)和脾内静脉属支(13例)入路,比较不同入路门静脉插管的技术成功率和并发症。结果经门静脉右支、左支和脾静脉入路的插管技术成功率分别为95.83%、96.15%和92.31%,差异无统计学意义(P均>0.05)。门静脉插管操作的并发症包括腹腔出血、气胸及血气胸、胆道系统损伤、假性动脉瘤形成和死亡。经脾静脉入路的并发症发生率显著高于其他两种入路(P均<0.05)。结论门静脉左支、右支及脾静脉入路是可供选择的经皮门静脉插管入路方式。病情允许时,应尽可能采用门静脉左支入路,而避免经脾静脉入路。Objective To investigate the significance of percutaneous portal vein accesses of the interventional therapy for portal vein diseases.Methods A total of 87 patients with portal vein diseases underwent percutaneous interventional treatment,48 of them received catheterization via the right portal vein tributaries,26 through the left portal vein tributaries,and 13 through the intrasplenic vein tributaries.The technical success and complication rates of the three catheterizations were compared retrospectively.Results The technical success rate of catheterization via the right portal vein,the left portal vein and the intrasplenic vein tributaries was 95.83%,96.15% and 92.31%,respectively.No statistical difference was found among them.The complications of the catheterizations included intraabdominal hemorrhage,pneumothorax or hemopneumothorax,biliary injury,pseudoaneurysm formation and death.The complication rate of catheterization via the intrasplenic vein tributaries was significantly higher than those via the right and left portal vein tributaries （all P0.05）.Conclution Via the right and left portal vein and intrasplenic vein tributaries are alternative accesses to the portal system for catheterization.Catheterization should be performed via the left portal vein rather than the intrasplenic vein tributaries when possible.

关 键 词：门静脉 导管插入术 穿刺术 导管 留置 

分 类 号：R543.6[医药卫生—心血管疾病]