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本院自1993年11月至1994年4月用经颈静脉肝内门体分流术(TIPS)收治肝硬化门脉高压患者5例。其中4例穿刺成功,1例失败,1例于术后2月余复发上消化道出血,1例手术后出现一过性肝性脑病症状。门静脉压力从术前35.5±3.3cmH_2O降至术后的24.3±4.5cmH_2O,术后测压显示门腔静脉压力差为8.4±0.7cmH_2O。术后1个月食管钡餐随访,食管静脉曲张均较术前明显改善。作者认为: TIPS操作较外科手术简便,适应证广,降低门脉压力可靠,是治疗肝硬化门脉高压症的有效方法。此外,内支架的选择对防止TIPS术后分流道狭窄有一定作用。
The hospital from November 1993 to April 1994 with transjugular intrahepatic portosystemic shunt (TIPS) in patients with cirrhosis and portal hypertension in 5 cases. Among them, 4 cases were successfully punctured, 1 case failed, 1 case had recurrent upper gastrointestinal bleeding more than 2 months after operation, and 1 case had transient hepatic encephalopathy after operation. Portal pressure decreased from 35.5 ± 3.3cmH_2O preoperatively to 24.3 ± 4.5cmH2O postoperatively. Postoperative pressure showed a portal venous pressure difference of 8.4 ± 0.7cmH_2O. Postoperative one month esophageal barium meal follow-up, esophageal varices were significantly improved compared with preoperative. The authors believe that: TIPS operation than surgery is simple, widely used to reduce the reliable portal pressure, is an effective method of treatment of cirrhosis and portal hypertension. In addition, the choice of internal stents to prevent TIPS postoperative shunts have a role.