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目的:探讨经颈静脉肝内门腔静脉内支架分流术(TIPS)治疗肝硬变门脉高压症的技术操作、并发症及其疗效。方法:采用经颈静脉肝内门腔静脉内支架分流术,治疗5例肝炎后肝硬变门脉高压症患者,分流通道直径为10mm。结果:4例成功,术后平均门脉压力由4.46kPa(45.50 cmH_2O)降为2.13 kPa(21.75 cmH_2O),消化道出血得到控制,胸腹水明显吸收,食管静脉曲张减轻或消失,临床症状得到改善。结论:TIPS 具有创伤小、疗效确切、合并症少、适应范围广等优点,是治疗门脉高压食管、胃底静脉曲张破裂出血的一种安全、有效的方法,其长期疗效有待进一步观察。
Objective: To investigate the technical operation, complications and curative effects of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of liver cirrhosis with portal hypertension. Methods: Five patients with posthepatitic cirrhosis and portal hypertension were treated with transjugular intrahepatic portosystemic shunt. The diameter of the shunt channel was 10 mm. Results: In 4 cases, the mean portal pressure decreased from 4.46 kPa (45.50 cmH2O) to 2.13 kPa (21.75 cm H2O), the control of gastrointestinal bleeding, the obvious absorption of pleural effusion and ascites, the disappearance of esophageal varices, and the improvement of clinical symptoms . Conclusion: TIPS is a safe and effective method for the treatment of portal hypertension and esophageal variceal bleeding due to its advantages of less trauma, exact effect, less comorbidities and wide range of application. Its long-term effect needs further observation.