【摘要】 目的应用彩色超声多普勒(CDF)评价胃冠状静脉栓塞术(GCVE)与经颈静脉肝内门体静脉分流术(TIPSS)双重介入方法治疗肝硬化门脉高压症(PVH)的效果。方法从临床确诊为肝硬化PVH患者中筛选已行GCVE的12例患者行TIPSS治疗,应用CDF于手术前后分别检测门静脉(主干及分支)、肝静脉、脾静脉和分流道(术后支撑管)管径、血流及肝、脾和腹水等情况,将手术前后检测结果进行对比分析。结果术后患者的门静脉、脾静脉血流速度显著改善P<0.01,管径明显缩小P<0.05,门脉压力降低,急性出血停止,分流道通畅;2例分别于术后6个月和18个月发生狭窄;前者12个月发生阻塞,后者经再次分流道扩张后恢复。结论双重介入方法可明显提高肝硬化PVH的临床治疗效果。更多还原

【Abstract】 Objective To ultrasonographically evaluate the effect of transjugular intrahepatic portal systemic stent shunt (TIPSS) and gastric coronary vein embolization (GCVE) for portal venous hypertension (PVH).Methods Twelve patients,who were diagnosized clinically as PVH and ever received to GCVE treatment previously,were explored to TIPSS intervention in this study.Doppler blood flow in portal vein (PV),hepatic vein (HV),splenic vein (SPV) and the stent prior-and post-operation were analyzed.Results The diameters of PV and SPV were reduced and blood-flow volumes were increased,(P<0.05).Acute bleeding were stopped and reduced and stent blood flows passed fluently.Only two cases appeared stenosis in the stent within 6 and 18 months respectively,after operation.The former case was seen complete occlusion in the stent,and the later was recovered after the second shunt operation.Conclusions Combination of TIPSS and GCVE could increase therapeutic effect on portal hypertension.更多还原