经皮肝穿刺肝内门体分流术的临床护理观察  

Clinical Nursing Observation on the Percutaneous Transhepatic Intrahepatic Portosystemic Shunt

作　　者：梁新苗[1] 王慧[1] 

机构地区：[1]中山大学附属第三医院,广东广州510630

出　　处：《临床医学工程》2012年第10期1797-1798,共2页Clinical Medicine & Engineering

摘　　要：目的介绍一种经皮经肝途径建立肝内门体分流道(简称PTIPS)的新方法,探讨其临床护理观察。方法 PTIPS在传统经颈内静脉肝内门体分流术(简称TIPS)的基础上,改变了穿刺路径,使TIPS手术当中最难的门静脉穿刺变得简单、容易、安全。我科自2009年11月至2012年1月,对25例门静脉海绵样变、各种原因导致门静脉血栓形成、闭塞等导致的反复消化道出血和顽固性腹水的特殊门静脉高压患者采用PTIPS技术,手术均获得成功,术后给予针对性临床观察和护理。结果 1例死亡,24例存活,患者生活质量获得明显改善。结论 PTIPS是TIPS的有效补充,进行围手术期的护理干预,至关重要,也是手术成功的关键。Objective To present an innovative procedure for portal hypertension of the portosystemic shunt creation via percutaneous transhepatic approach, and study the nursing observation for these cases. Methods Percntaneous transhepatic intrahepatic portosystemic shunt （PTIPS） procedure was performed based on the orthodox transjugular intrahepatic portosystemic shunt （TIPS）, which changed the puncture approach via percutaneous transhepatic, and made puncturing intraheptic branch of portal vein more easy and safe. Between November 2009 and January 2012, 25 patients with portal hypertension underwent PTIPS procedure. The procedure was technically successful in all patients. After the procedure, some pertinent clinical observation and nursing measures were applied. Results Of the 25 patients, one case developed hepatic coma and died after 5 days, who had Child-Pugh class C disease, and recurrent acute variceal hemorrhea before PTIPS, the other 24 patients had still survived. The patients＇ quality of life was improved remarkably. Conclusions The PTIPS procedure is safe and effecative for the treatment of portal hypertension with exceptionally challenging anatomy. It is an available supplement for orthodox TIPS. Applying some pertinent clinical observation and nursing intervention measures at the perioperative period is very important, and is also the key to successful operation.

关 键 词：肝内门体分流道 临床观察 护理 

分 类 号：R472.9[医药卫生—护理学]