摘要
ＴＩＰＳ术治疗５０例，其中４９例为肝炎后肝硬化，１例为门静脉海绵窦样变，４５例有反复呕血及黑便史，５例无上消化道出血史，均有中－重度食管静脉曲张。１６例有中－大量腹水。结果：（１）４５例门静脉建立有效分流，成功率为９０％。门静脉主干压力从术前的３．９５±０．８５ｋＰａ降至２．３３±０．７２ｋＰａ（Ｐ＜０．００１）。（２）胃镜检查ＴＩＰＳ术后食管静脉曲张消失和基本消失率为４１．４３％，减轻为３７．９％。（３）术后腹水消失或减轻为６２％。（４）并发症与操作有关的为１２％，总发生率为３６％。（５）术后肝功能观察：血清总胆红质升高，血清白蛋白降低。随访１９９３年３月至１９９４年３月置入Ｇｉａｎｔｕｒｃ－ＲｏｓｃｈＺ型、网型支架的２４例患者，随访３个月至２２个月者２０例，支架狭窄、闭塞率半年为２０％，１年为５５％；复发出血８例为４０％。１９９４年４月至１９９５年１月置入ｗａｌｌｓｔｅｎｔ支架的２１例中，尚无支架闭塞及反复出血。全组现共死亡８例，死亡率为１５．６％
Among 50
patients heald with TIP8,49 were posthepatitis cirrhosis onecavernous transformation of portal
vein,45 of them had history of repeatedhematemesis and melena 5 had no history of upper
gastrointestinal bleeding,but withmoderate to severe varices.16 had moderate to massive
ascites,According to child’sclassification,31 patients were in class A,13 in class B and 6 in
class C. The resultswere as follows:1.The portal venous shunts were successfully set up in 45
patients,thesuccessful rate was 90%,the presssure of portal venous trunk dropped from 3.95±
0.85kPa to 2.33 ± 0.72kPa (P< 0.001);2.The gastroscopy showed disappearance of varices
in41.4%,reduction in caliter in 37.9%the total effective rate was 79.3%:Ascitesdisappeared the
total rate of or decreased in 62%;4.Complication relaterd to manuveurwas l2%,the total rate of
complication was 36%,Eight patients died due to rebleedingor hepatic failure during a of
follow-up period, of 3～22 months
出处
《中华消化杂志》
CAS
CSCD
北大核心
1996年第1期26-28,共3页
Chinese Journal of Digestion
关键词
分流术
出血
门脉高血压
治疗
TIPS
Portal hypertensionTrannsjugular intrahepatic
portosystemicshunt(TIPS)
