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目的：经皮穿肝门静脉是介入放射学中的常见操作方法之一，现仍存在一定的并发症，且大多与操作损伤有关。采取改良ＣＯＰＥ穿刺导引系统可望进一步减少并发症。材料与方法：１４例患者用改良ＣＯＰＥ穿刺导引系统经皮穿肝门静脉，其中３例肝脏体积很小，且伴大量腹水。改良ＣＯＰＥ穿刺导引系统包括：①２２Ｇ千叶针，内可通过０．０１８″导丝；②０．０１８″导丝；③改良ＣＯＰＥ穿刺套管，内芯为２２Ｇ不锈钢套管，中间为Ｆ４扩引管，两者均可通过０．０１８″导丝，外套管为Ｆ５，内可通过０．０３８″导丝。用２２Ｇ千叶针穿入门静脉大分支后用０．０１８″导丝经千叶针进至门静脉主干，更换改良ＣＯＰＥ穿刺套管于门静脉后留下外套管，再经０．０３８″导丝后即可更换各种形态的Ｆ５导管进行操作。结果：所有１４例患者均成功地完成了经皮穿肝门静脉操作，无１例出现并发症。结论：改良ＣＯＰＥ穿刺导引系统是一种安全性很高又非常实用的穿刺导引系统，适用于经皮穿肝及其他脏器的穿刺引流，尤其适宜于病情较重或一般情况欠佳者，值得在临床上推广。
OBJECTIVE: Percutaneous transhepatic portal vein is one of the common operation methods in interventional radiology. There are still some complications, and most of them are related to operational injury. Adoption of a modified COPE puncture guidance system is expected to further reduce the complications. MATERIALS AND METHODS: Twenty-four patients underwent percutaneous transhepatic portal vein with a modified COPE guidance system. Three of them had a small volume with a large amount of ascites. Improved COPE puncture guidance system includes: ① 22G Chiba needles, which can pass 0.018 “guide wire; ② 0.018” guide wire; ③ modified COPE puncture cannula, the inner core of 22G stainless steel cannula, the middle of the F4 expansion Tubes, both through the 0.018 “guidewire and the outer cannula to F5, can pass through the 0.038” guidewire. After penetrating the portal vein branch with a 22G chiral needle, a 0.018 “guide wire was passed through the Chiba needle into the main portal vein. After the modified COPE puncture cannula was replaced, a jacket tube was left after passing through the portal vein. After passing through the 0.038” You can replace the various forms of F5 catheter operation. RESULTS: Percutaneous transhepatic portal vein procedures were successfully performed in all 14 patients and none of the patients had complications. Conclusion: The modified COPE puncture guidance system is a safe and practical puncture guidance system, which is suitable for puncture and drainage of percutaneous liver and other organs. It is especially suitable for patients who are in severe condition or in general poor condition , It is worth clinical promotion.