改良式经颈静脉肝内门腔静脉分流术治疗肝静脉闭塞型Buddi-Chiari综合征  

Extensive techniques of TIPS in Buddi-Chiari syndrome with occlusive hepatic veins

作　　者：单鸿[1] 关守海[1] 姜在波[1] 朱康顺[1] 黄明声[1] 李征然[1] 朱文科[1] 

机构地区：[1]中山大学第三医院放射科,广州510630

出　　处：《中华放射学杂志》2002年第9期787-791,共5页Chinese Journal of Radiology

摘　　要：目的　阐述改良式经颈静脉肝内门腔静脉分流术 (TIPS)的技术步骤和评价其对肝静脉闭塞型Buddi Chiari综合征的治疗效果。方法　 11例被诊断为Buddi Chiari综合征的患者 ,经影像学证实为肝静脉广泛狭窄和闭塞后 ,接受改良式TIPS技术治疗 ,TIPS改良技术的关键在于假想肝静脉通道的设计与建立 ;术后对其门脉系统压力变化、分流道血流改变及内支架开通状况进行了 2 4个月的随访。结果　 11例患者全部成功地建立肝内门静脉 下腔静脉分流通道 ,临床症状得到改善 ;门静脉主干压力由分流前的平均 (4 6 2± 0 5 2 )kPa (1kPa =10 .2cmH2 O)下降至分流术后的 (2 16± 0 2 1)kPa ;术后 2 4个月随访 ,分流道血液最大流率 (Vmax)为 (5 6 2± 3 5 0 )cm/s ,内支架通畅 7(7/ 11)例。结论　改良式TIPS技术具有高技术成功率 ,为肝静脉闭塞型BuddiObjective To elaborate the ameliorative technique steps of transjugular intrahepatic portosystemic shunt (TIPS) and to evaluate its therapeutic effects to Buddi Chiari syndrome with occlusive hepatic veins Methods Eleven patients were treated by the improved methods of TIPS, who were diagnosed as Buddi Chiari syndrome with widespread stenosis or occlusive lesions of hepatic veins and verified through imagiology Key points of the extensive techniques of TIPS were to design and build the access to the artificial hepatic vein The changes of portal vein pressure, shunt blood flow, and stent patency posterior to the procedure were assessed and followed up for 24 months Results The intrahepatic shunt between portal vein and inferior vena cava was successfully built and good clinical responses were obtained in all patients The main portal pressure decreased from (4 62±0 52) kPa ( ±s ) to (2 16±0 21) kPa posterior to the shunt The maximum velocity of shunt blood flow was (56 2±3 50) cm/s and stent patency was 7/11 at 24 months after the procedure Conclusion The extensive TIPS has a high successful technique rate, and is worthy of a new therapeutic means to Buddi Chiari syndrome with occlusive hepatic veins

关 键 词：经颈静脉肝内门腔静脉分流术 肝静脉闭塞型 Buddi-Chiari综合征 

分 类 号：R815[医药卫生—放射医学]