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报告12例急诊经颈静脉途径肝内门体分流术,旨在评价临床疗效及探讨急诊情况下的有关治疗技术问题。12例中男性患者10例,女性2例,年龄42~72岁,均为其他保守治疗方法所不能控制的食管胃静脉曲张破裂大出血患者,10例在三腔双囊管压迫下行TIPSS。结果:11例穿刺门脉成功并建立起有效分流,1例因门脉海绵状变性而终止分流术;除1例未能控制大出血(与选择栓塞剂不当有关)、于术后1.5小时死亡外,其余技术成功的病例均获得优良的止血效果。初步结论:TIPSS对于其他方法所不能控制的静脉曲张破裂大出血患者是一有效的救治措施。为及时控制出血,作者推荐常规用钢丝圈栓塞曲张的静脉。
The report of 12 cases of emergency via the jugular vein portal shunt, aimed to evaluate the clinical efficacy and to explore the emergency treatment of technical problems. Among the 12 patients, 10 were male and 2 were women, ranging in age from 42 to 72 years. All of them were patients with esophagogastric variceal bleeding that could not be controlled by other conservative treatment methods. TIPSS was performed in 10 patients under triple-lumen double-capillaries compression. Results: Successful puncture of the portal vein was established in 11 cases and an effective shunt was established. In 1 case, the shunt was terminated due to cavernous degeneration of the portal vein. One case failed to control the major bleeding (related to improper choice of embolic agent) Death, the rest of the successful cases of technology have been excellent hemostatic effect. Preliminary conclusions: TIPSS is an effective treatment for patients with variceal bleeding who can not be controlled by other methods. In order to control bleeding in time, the authors recommend routine use of wire ring embolism varicose veins.