双导丝一步穿刺法及经皮肝穿刺门静脉造影在 TIPS 中的应用

摘要

Objective To investigate the operational approach and value of dual-wire one-step puncture and percutaneous portal vein puncture portography in transjugular intrahepatic portosystemic shunt (TIPS).Methods Twenty-one cirrhosis patients with gastroesophageal varices bleeding received treatment with TIPS by dual-wire one-step puncture and percutaneous portal vein puncture portography.Results All of these patients were successfully operated on with TIPS, with average operation time of (152.41 ±50.38)min and surgery puncture times of (2.50 ± 1 .54).Meanwhile,TIPS treatment significantly attenuated the portal venous pressure and liver function,with success rate as 100% and mortality as 5%.Conclusion The method of TIPS using dual-wire one-step puncture and percutaneous portal vein puncture portography could reduce operation difficulty,which is worth to be popularized and applied.%目的：探讨双导丝一步穿刺法及经皮肝穿刺门静脉造影在 TIPS 中的操作方法及应用价值。方法采用双导丝一步穿刺法及经皮肝穿刺门静脉造影法，对21例肝硬化并食管胃底静脉曲张破裂出血患者行 TIPS 术。结果21例患者均成功实施 TIPS 手术，手术时间（152．41±50．38）min，手术穿刺针数（2．50±1．54）针，结果显示改良 TIPS 术可显著降低门静脉压力，改善肝功能，手术成功率100％，病死率5％。结论采用双导丝一步穿刺法及经皮肝穿刺门静脉造影的方法行 TIPS 术，能降低手术难度，值得临床推广应用。