经颈静脉楔入法肝静脉CO2造影术在经颈静脉肝内门体分流术中的应用  

Adopting wedge hepatic venography with CO2 during transjugular intrahepatic portosystemic shunt procedures

作　　者：张林鹏[1] 陈松涛[1] 石秀兰[1] 杨敏玲[2] 张丽[1] 刘嘉[1] 贾玲[1] 孙志刚[1] 杨国玲 李玉杰[1] 裴伟俭[1] 

机构地区：[1]太原市第三人民医院影像介入科,030012 [2]山西医科大学第一附属医院介入科 [3]解放军海军门诊部丰台卫生所

出　　处：《中华放射学杂志》2012年第5期456-458,共3页Chinese Journal of Radiology

摘　　要：目的改进经颈静脉肝内门体分流术（TIPS）门静脉造影方法，探索安全、省时的肝静脉造影和手术方法。方法对6例经颈静脉楔入法肝静脉CO2造影和7例穿刺股动脉经肠系膜下动脉间接门静脉显影方法进行对比，评价2种门静脉造影方法的门静脉图像质量、TIPS手术效果、患者术后并发症发生情况及恢复情况。结果6例楔人法肝静脉CO2造影均获得满意图像，因为凝血功能差终止手术1例，5例手术成功。7例穿刺股动脉经肠系膜下动脉间接门静脉造影获得手术所需图像，1例因门静脉慢性梗阻手术失败，6例手术成功，其中1例术后动脉穿刺点出现血肿。结论在TIPS手术中，应用楔入法肝静脉CO2造影较肠系膜下动脉造影显示门静脉解剖结构更清晰、方便和安全。Objective To renovate angiography in identifying portal vein anatomy during transjugular intrahepatic portosystemic shunt （TIPS） procedures, saving the time of TIPS procedures, decreasing the risk of the complications of the post-procedure. Methods The difference between the Wedge hepatic venography with Carbon Dioxide in 6 cases and Inferior Mesenterlc artery angiography in 7 cases during TIPS procedures were compared in the identification of portal vein anatomy. The quality of images, their effects on the procedures, the complications and the recovery post-procedure were evaluated. Results Using CO2, the portal veins were opacified in all 6 cases. TIPS procedures succeeded in all cases except 1 case because of poor coagulation function. Using Inferior Mesenteric artery angiography, the portal veins were opacified in all 7 cases. TIPS procedure succeeded in all cases except 1 case because of chronic portal occlusion. Puncture-site hematoma occurred in 1 case after TIPS procedure. Conclusion Wedge hepatic venography with Carbon Dioxide is superior, safer and more convenient than Inferior Mesenteric Artery angiography in identifying portal vein anatomy during TIPS.

关 键 词：门体分流术 经颈静脉肝内 门静脉造影术 造影剂 二氧化碳 对比研究 

分 类 号：R575.2[医药卫生—消化系统]