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腹腔静脉分流术(PVS)是治疗腹水的方法之一.目前应用最广的是LeVeen分流,自1974年以来,到1979年世界范围内已施行5000多例.本文综述了LeVeen分流的作用机制、并发症、适应症和禁忌症.分流机制:分流的目的是将腹水回流至血管腔,并防止血液反流.分流管输入端带有多个侧孔,将一端自由地置入腹腔内,并与嵌在腹壁肌层内的单向活瓣连接.输出端向上通过胸壁皮下连接颈内静脉,远端位于上腔静脉与右心房交界的附近.硅胶钟形辦膜位于腹腔端出口附近,通过抗压环起调节作用.正常情况下瓣膜处于关闭状态.当腹腔内压力与中心静脉压力梯度超过3～4cmH_2O时,瓣膜从腹腔侧被冲开,腹水流入静脉端.当压力梯度下降时,抗压环张力牵拉使活瓣关闭,防止血液向胸腔端反流.
Intraperitoneal shunt (PVS) is one of the methods to treat ascites.At present, the most widely used is LeVeen shunt, which has been implemented in more than 5000 cases worldwide since 1979. This paper reviews the mechanism of LeVeen shunting, Complications, Indications and Contraindications. Shunt Mechanism: The purpose of shunting is to return ascites to the lumen of the blood vessel and prevent blood reflux. The shunt tube has multiple side holes at its input end and one end is freely placed in the abdominal cavity And embedded in the abdominal wall of the one-way flap connected to the output of the upward through the chest wall subcutaneous connection of the internal jugular vein, the distal located in the superior vena cava and the right atrium near the junction. Silicone bell-shaped film located near the exit of the abdominal cavity through The pressure ring plays a regulatory role, and the valve is normally closed.When the intra-abdominal pressure and the central venous pressure gradient exceed 3 ~ 4cmH_2O, the valve is punctured from the side of the abdominal cavity and the ascites flows into the venous end.When the pressure gradient is decreased, Tension tension ring pull the valve closed to prevent blood reflux to the thoracic cavity.