【摘要】：目的探討經(jīng)頸靜脈肝內(nèi)門(mén)體靜脈分流術(shù)(TIPS)門(mén)靜脈左支分流道內(nèi)支架位置對(duì)遠(yuǎn)期療效的影響。方法回顧性分析2012年1月至2014年12月采用門(mén)靜脈左支TIPS術(shù)治療的527例門(mén)靜脈高壓上消化道出血患者臨床資料。根據(jù)支架是否進(jìn)入門(mén)靜脈主干分為門(mén)靜脈左支組(n=318)和門(mén)靜脈主干組(n=209),比較兩組手術(shù)成功率、分流道血流動(dòng)力學(xué)、支架通暢率、肝性腦病發(fā)生率、再出血率等。結(jié)果兩組手術(shù)成功率均為100%。術(shù)后1年門(mén)靜脈左支組分流道流速及流量參數(shù)均顯著高于門(mén)靜脈主干組(P0.05)。1年隨訪(fǎng)期間門(mén)靜脈左支組、門(mén)靜脈主干組分流道功能異常率分別為1.26%(4/318)、5.74%(12/209)(P=0.003),肝性腦病發(fā)生率分別為0.31%(1/318)、4.31%(9/209)(P=0.001),再出血率分別為0.94%(3/318)、2.87%(6/209)(P=0.095)。結(jié)論 TIPS術(shù)中穿刺門(mén)靜脈左支并將支架留植左支內(nèi),能獲得較低的分流道功能異常率及肝性腦病發(fā)生率。
[Abstract]:Objective to investigate the effect of stent placement in the left portal vein shunt of (TIPS) after intrahepatic portosystemic shunt via jugular vein. Methods the clinical data of 527 patients with upper gastrointestinal hemorrhage due to portal hypertension treated with TIPS from January 2012 to December 2014 were retrospectively analyzed. According to whether the stents entered the portal vein trunk, they were divided into two groups: the left portal vein branch group (nf318) and the portal vein trunk group (nm209). The success rate, shunt hemodynamics, stent patency rate, hepatic encephalopathy rate and rebleeding rate were compared between the two groups. Results the successful rate of operation was 100 and 100 in both groups. The shunt velocity and flow parameters in the left portal vein branch group were significantly higher than those in the portal vein trunk group one year after operation (P0.05). The incidence of hepatic encephalopathy was 0.31% (1 / 318) 4.31% (9 / 209) (P0. 001), and the rebleeding rate was 0. 94% (3 / 318) 2.87% (6 / 209) (P0. 095). Conclusion puncture of the left branch of portal vein and stenting in the left branch of portal vein during TIPS can obtain a lower rate of shunt dysfunction and hepatic encephalopathy.
【作者單位】： 石家莊市第五醫(yī)院介入科;空軍總醫(yī)院放射科;解放軍第273醫(yī)院感染科;
【分類(lèi)號(hào)】：R575.21
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本文編號(hào)：2159842