覆膜支架联合长裸支架在TIPS治疗中的应用  

Application of stent-grafts combined with long bare stents in transjugular intrahepatic portosystemic shunt

作　　者：邓小军[1] 张宏文[1] 孙鑫国[1] 段诗姣[1] 谢卫华[1] 刘琼[1] 

机构地区：[1]南华大学附属南华医院介入科,湖南省衡阳市421002

出　　处：《世界华人消化杂志》2016年第22期3428-3432,共5页World Chinese Journal of Digestology

摘　　要：目的:评估覆膜支架联合长裸支架在经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)中的应用价值.方法:对南华大学附属南华医院2012-01/2015-01 22例肝硬化食管胃底静脉曲张患者采用覆膜支架联合长裸支架行TIPS治疗.结果:TIPS治疗的技术成功率为100%,术前门静脉压力43.25 cm H2O±4.56 cm H2O(l cm H2O=0.098 k Pa)降至23.78 cm H2O±5.11 c m H2O(t=21.423,P<0.01).造影见食管胃底曲张静脉消失,术后患者肝功明显改善,食管胃底静脉曲张程度明显减轻,无急性肝衰竭病例发生.随访6-24 mo,术后6、12、24 m o的累积分流道通畅率分别为95.4%(21/22)、90.9%(20/22)、86.3%(19/22).无"盖帽"情况发生.结论:采用覆膜支架联合长裸支架套叠技术能明显提高分流道的通畅率,为门脉高压症患者的肝内门体分流提供了是一种安全、有效的治疗方法,具有重要的临床应用价值.AIM：To assess the efficacy of stent-grafts combined with long bare stents in transjugular intrahepatic portosystemic shunt（TIPS）.METHODS：A total of 22 patients with gastroesophageal varices underwent TIPS therapies using stent-grafts combined with long bare stents from January 2012 to January 2015 at the Affiliated Nanhua Hospital of Nanhua University.RESULTS：The technical success rate of TIPS was 100%.The portal vein pressure declined from 43.25 cmH_2O ± 4.56 cmH_2O（1 cmH_2O =0.098 kPa） to 23.78 cmH_2O ± 5.11 cmH_2O（t =21.423,P〈0.01） after operation.Angiography showed that gastroesophageal varices disappeared in all patients.Both liver function and gastroesophageal varices markedly improved.During a follow-up period of 6-24 mo,the cumulative primary patency rates were 95.4%（21/22）,90.9%（20/22）,and 86.3%（19/22） at 6,12 and 24 mo after the procedure,respectively.No shunt occlusion occurred during the follow-up period.CONCLUSION：TIPS using stent-grafts combined with long bare stents can markedly increase the shunt patency rate.Double stent technique is both safe and effective for the treatment of portal hypertension with exceptionally challenging anatomy.

关 键 词：经颈静脉肝内门腔分流术 门脉高压症 覆膜支架 介入性 

分 类 号：R575.2[医药卫生—消化系统]