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肝性胸水是门脉高压的少见并发症,保守疗法对顽固性肝性胸水难以奏效。研究旨在确定经颈静脉肝内门体分流(TIPS)对有症状的、顽固性胸水的治疗效果。 病人和方法:1992年3月到1995年11月,24例有持续症状的(如呼吸困难、端坐呼吸)肝性胸水病人接受TIPS。全部病人都有肝病和门脉高压的临床、实验室和放射检查证据。虽经限钠限水以及使用大剂量的利尿剂,所有病人仍有持续性右侧胸水,并曾多次胸穿。采用TIPS标准技术。TIPS和静脉多普勒、胸部X线检查每3~6个月1次。胸水完全消除或胸腔积液减少,呼吸道症状完全缓解为成功;呼吸道症状改善、减少了频繁的胸穿为部分成功;胸穿次数不变为失败;平均随诊时间为7.2个月(0.25~49个月)。 结果与讨论:24例病人TIPS全部成功。操
Hepatic pleural effusion is a rare complication of portal hypertension, conservative treatment of intractable hepatic pleural effusion is difficult to work. The aim of the study was to determine the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of symptomatic and refractory pleural effusion. PATIENTS AND METHODS: From March 1992 to November 1995, 24 patients with persistent symptoms of hepatic hydrothorax (eg, dyspnea, sitting-on) received TIPS. All patients had clinical, laboratory and radiographic evidence of liver disease and portal hypertension. Despite limited sodium restriction and the use of large doses of diuretics, all patients still had persistent right pleural effusion and had multiple chest wear. Using TIPS standard technology. TIPS and venous Doppler, chest X-ray examination once every 3 to 6 months. Complete reduction of pleural effusion or pleural effusion decreased, respiratory symptoms completely relieved as success; respiratory symptoms improved, reducing the frequent chest wear as part of the success; chest wear unchanged for failure; average follow-up time of 7.2 months (0.25 ~ 49 Month). Results and Discussion: Twenty-four patients successfully completed TIPS. Fuck