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目的探讨彩色多普勒超声在经颈静脉肝内门体分流术(TIPS)联合食管胃底曲张静脉栓塞术(SEVE)术后随访中的应用价值。方法选择2012年5月至2016年6月收治的20例肝硬化门静脉高压患者,均行TIPS联合SEVE,超声于术前及术后1周,1、6和12个月测量门静脉内径、最大流速及脾静脉流速,于术后测量支架内血流速度,术后随访时间为12个月。结果 20例患者术后随访期间无一例死亡,生存率为100%;发生肝性脑病1例;支架狭窄及闭塞各1例。术后各时间点门静脉内径无明显变化(P均>0.05),门静脉血流速度较术前显著增加(P均<0.05),6个月以后各时间点门静脉血流速度较之前呈下降改变(P均<0.05),并维持相对稳定。术分流道支架血流速度术后1周及3、6个月相互比较无明显差异(P均>0.05),6个月以后各时间点血流速度较之前呈下降改变(P均<0.05),并维持相对稳定。结论彩色多普勒超声可以有效方便地检测术后支架和门静脉内血流速度,是TIPS术前检查及术后随访的重要方法。
Objective To investigate the value of color Doppler ultrasound in the follow-up of transjugular intrahepatic portosystemic shunt (TIPS) and esophageal varices embolization (SEVE). Methods Twenty patients with portal hypertension of cirrhosis who were treated from May 2012 to June 2016 were treated with TIPS combined with SEVE. The portal vein diameter, maximum flow velocity And splenic vein flow velocity, the stent blood flow velocity was measured after operation, the follow-up time was 12 months. Results None of the 20 patients died during the follow-up. The survival rate was 100%. Hepatic encephalopathy occurred in 1 case. Stent stenosis and occlusion in 1 case. There was no significant change in the diameter of portal vein at all time points after operation (all P> 0.05), and the portal vein velocity increased significantly (P <0.05). After 6 months, portal vein velocity decreased P <0.05), and remained relatively stable. There was no significant difference in the blood flow velocities between 1 and 3 months and 6 months after surgery (P> 0.05). After 6 months, the blood flow velocity decreased at various time points (P <0.05) , And maintain relatively stable. Conclusion Color Doppler ultrasound can effectively and conveniently detect the blood flow velocity in the stent and the portal vein, which is an important method for preoperative TIPS and follow-up.