摘要
目的 探讨经皮门静脉穿刺改良经颈内静脉肝内门体分流术（TIPS）较常规TIPS方法的优越性及临床疗效.方法 回顾性分析空军总医院2009年3月～2011年9月采用TIPS技术治疗门脉高压急性上消化道出血患者36例,其中15例采用常规TIPS技术,21例采用经皮肝穿刺门静脉造影改良TIPS技术.结果 改良TIPS组与常规TIPS组相比,手术时间显著缩短（183.69±56.77 vs 140.32±43.56）、手术开始至胃冠状静脉封堵时间显著缩短（130.81±66.39 vs 12.53±13.18）、穿刺针数显著减少（7.57±3.14 vs 4.16±2.73）、改良TIPS组手术成功率100％,常规TIPS组手术成功率80％,两组治疗均可显著降低门静脉压力.结论 超声引导下经皮门静脉穿刺造影,可标识定位指导TIPS操作,并可在第一时间封堵胃冠状静脉出血,提高了TIPS穿刺的准确性和安全性,可行性优于常规TIPS操作方法.
Objective To compare superiorities and clinical efficacy of percutaneous portal vein puncture improved TIPS and conventional TIPS.Methods 36 portal hypertension with acute upper gastrointestinal bleeding from 2009 to 2011 at Air Force General Hospital of Chinese PLA were investigated retrospectively,15 cases with conventional TIPS,21 with percutaneous portal vein puncture improved TIPS.Results Compared with the conventional TIPS,the improved TIPS has a significantly shorter operative time （183.69 ± 56.77 vs 140.32 ± 43.56）,a significantly shorter time from the beginning of operation to gastric coronary vein occlusion （130.81 ± 66.39 vs 12.53 ± 13.18）,a significant reduction in the number of puncture （7.57 ± 3.14 vs 4.16 ± 2.73）.Improved TIPS group 100% success rate of operation,80% in conventional TIPS,the two groups both can reduce portal pressure significantly.Conclusion Ultrasound-guided percutaneous portal vein puncture angiography can identify the position and guide TIPS operation,block gastric coronary vein bleeding in the first time,and improve the accuracy and safety,and the feasibility is superior to conventional TIPS.
出处
《肝胆外科杂志》
2013年第6期415-418,共4页
Journal of Hepatobiliary Surgery
关键词
门体分流术
经颈内静脉
TIPS
超声引导
经皮门静脉穿刺
门脉高压
急性上消化道出血
Portosystemic shunt
Jugular vein
TIPS
Ultrasound-guided
Percutaneous portal vein puncture
Portal hypertension
Acute upper gastrointestinal bleeding
作者简介
【通讯作者】张洪义。
