挑战门脉高压经颈静脉肝内门体分流术禁忌证  

Challenge the contraindications of TIPS treatment for portal hypertension:6 cases

作　　者：张洪义[1] 冯志强[1] 李新慧[1] 刘洋[1] 汪鑫[1] 陈智[1] 赵二鹏[1] 

机构地区：[1]解放军空军总医院肝胆外科,北京100142

出　　处：《中国医刊》2016年第1期56-60,共5页Chinese Journal of Medicine

摘　　要：目的探讨复杂高龄门脉高压经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)治疗的可行性和手术特点。方法回顾性分析2014年8月至2015年4月本院收治的6例复杂高龄门静脉高压患者的临床资料,其中3例为门静脉高压上消化道出血,2例为门静脉高压致顽固性腹水,1例既有上消化道出血,又有顽固性腹水,统计其手术成功率、相应症状缓解率、肝性脑病发生率、手术时间、穿刺针数、血氨及肝功能变化情况。结果 6例患者手术成功率、相应症状缓解率均为100%,肝性脑病发生率为0。结论高龄复杂门脉高压行TIPS治疗是安全、可行的,这需要医师有一定的临床操作经验,术后需加强综合治疗。Objective To investigate the feasibility and operation characteristics of the treatment of complex and aged TIPS treatment of portal hypertension. Method We analyse the operation characteristics and postoperative treatment of 6 patients with complex and aged portal hypertension treated with TIPS between August 2014 and April 2015 analyzed retrospectively, including 3 cases of portal hypertension upper gastrointestinal bleeding, 2 cases of portal hypertension with refractory ascites, 1 case of portal hypertension both with upper gastrointestinal bleeding and refractory ascites.Statistics the surgical success and corresponding symptoms remission rate, incidence of hepatic encephalopathy, operation time, puncturetime, blood ammonia, liver function changes. Result The surgical success and corresponding symptoms remission rate are 100%, the incidence of hepatic encephalopathy is 0, the list says the changes of blood ammonia and liver function. Conclusion Complex and aged TIPS treatment of portal hypertension is safe and feasible, this requires physicians have certain clinical operation experience, strengthen the comprehensive treatment after surgery.

关 键 词：经颈静脉肝内门体分流术 门脉高压 治疗 

分 类 号：R575[医药卫生—消化系统]