经颈静脉肝内门静脉左支门体分流中支架位置对远期疗效的影响

发布时间：2018-08-02 15:14

【摘要】：目的探讨经颈静脉肝内门体静脉分流术(TIPS)门静脉左支分流道内支架位置对远期疗效的影响。方法回顾性分析2012年1月至2014年12月采用门静脉左支TIPS术治疗的527例门静脉高压上消化道出血患者临床资料。根据支架是否进入门静脉主干分为门静脉左支组(n=318)和门静脉主干组(n=209),比较两组手术成功率、分流道血流动力学、支架通畅率、肝性脑病发生率、再出血率等。结果两组手术成功率均为100%。术后1年门静脉左支组分流道流速及流量参数均显著高于门静脉主干组(P0.05)。1年随访期间门静脉左支组、门静脉主干组分流道功能异常率分别为1.26%(4/318)、5.74%(12/209)(P=0.003),肝性脑病发生率分别为0.31%(1/318)、4.31%(9/209)(P=0.001),再出血率分别为0.94%(3/318)、2.87%(6/209)(P=0.095)。结论 TIPS术中穿刺门静脉左支并将支架留植左支内,能获得较低的分流道功能异常率及肝性脑病发生率。
[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.
【作者单位】： 石家庄市第五医院介入科;空军总医院放射科;解放军第273医院感染科;
【分类号】：R575.21
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