摘要
随访１０ 例经颈静脉肝内门体分流术（ＴＩＰＳＳ） 后的患者，Ｔｉｐｓｓ 的成功率为９０－９９ ％（１０／１１） 。建立分流后门脉压从术前的３－８４ ±０－５２ｋＰａ 降至２－２８ ±０－３１ｋＰａ，（ Ｐ＜ ０－０１） 。１１ 例患者中，ＣｈｉｌｄＡ１ 例、ＣｈｉｌｄＢ６ 例、ＣｈｉｌｄＣ４ 例。所有患者进行临床和Ｄｏｐｐｌｅｒ 超声随访。１０ 例患者在６ － ３６ 月的随访中，２ 例死亡，８ 例生存，平均生存时间为１５ 月。Ｔｉｐｓｓ 后再出血３ 例（３０ ％ ） ，其中１例死亡，与分流道狭窄和阻塞有关（１ 例狭窄，２ 例阻塞） 。随访中发生肝性脑病２ 例（２０ ％ ） ，经内科治疗满意。７ 例Ｔｉｐｓｓ 后腹水减少或者消失（１００％ ），随访中再次腹水增多５ 例（７１－４％ ） 。结论：Ｔｉｐｓｓ 在控制食管静脉曲张出血和顽固性腹水方面是一种有效的新技术，但是，中远期分流道的狭窄和阻塞发生率高。
We assessed the long term following up efficancy oftransjugularintrahepatic portosys temic stentshuntsin 10 patients-Shunt wassuccessfulin 10 of11 patients(90-9 % )-Portalpressure be fore and after shunt were 3-84±0-52 kPa and 2-28 ±0-31 kParespectively ,and were also statistically significant( P< 0-01)-Accordingto thechilds pugh clasification ,1 patient was class A,6 patients were class Band 4 class C-Patients were followed clinically,and shunts were detected by Doppler ultrasono graph-During 6 36 months of follow up in 10 patients,2died.At present 8 patient●s are alive,With a mean Survivalof 15 months-Varicealrebleeding occured in 3 patients (30% ) ,one of whom died,and wasalways associated with shunt stenosis and occlusion-Clinical encephalopathy was induced in 2 pa tients(20 % ) following Tipss,and a11 responded to medicaltherapy- Ascitesimproved after Tipssin 7 patients(100 % ) ,but reaccumulated in 5 patients (71-4 % )-In conclusion :Tipssis a usefultreatment forvarcealbleeding and resistant ascites,but shunt disfunction found in long term follow up occur fre quently,and regularsurveillanceis necessary-
出处
《临床肝胆病杂志》
CAS
北大核心
1999年第2期118-120,共3页
Journal of Clinical Hepatology
