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目的对临床上采用两种途经置管溶栓治疗门静脉血栓的病例进行回顾性研究,并对比两种方法的优缺点。材料方法病例19人,男性11人,女性8人,年龄21-63岁,平均49.7岁。采用经皮经肝途径10人,颈内静脉途径9人,分别对两种方法的疗效、并发症进行随访。疗效分为三等:A,血栓大部分消除,症状消失;B,血栓消除不明显,但侧枝循环建立丰富,症状缓解。C.血栓末消除,症状未缓解。结果采用经皮肝穿途径,技术成功率达100%,有效率达82%,严重并发症的发生率30%(3/10);采用TIPSS途径,技术成功率66.7%,有效率86.7%(5/6),严重并发症发生率11.1%(1/9)。结论经皮经肝穿途径和经TIPSS途径穿刺门静脉并置管进行溶栓治疗,疗效良好,但必须严格规范操作及加强术后观察护理以防治相应的并发症。
Objective To retrospectively study two cases of portal vein thrombosis treated with catheterization and thrombolysis clinically and to compare the advantages and disadvantages of the two methods. Materials and Methods 19 cases, 11 males and 8 females, aged 21-63 years, an average of 49.7 years old. Percutaneous transhepatic approach of 10 people, 9 people in the jugular vein, respectively, the efficacy of two methods, complications were followed up. Efficacy is divided into three categories: A, most of the elimination of thrombosis, the symptoms disappear; B, thrombosis is not obvious, but the establishment of collateral circulation rich, symptoms ease. C. End of the thrombus disappeared, the symptoms did not ease. Results The successful rate was 100%, the effective rate was 82% and the serious complication rate was 30% (3/10). The technical success rate was 66.7% and the effective rate was 86.7% 5/6). The incidence of serious complications was 11.1% (1/9). Conclusion Percutaneous transhepatic approach and TIPSS approach to puncture the portal vein with catheter for thrombolytic therapy are effective. However, it is necessary to strictly regulate the operation and strengthen postoperative observation and nursing to prevent and treat the corresponding complications.