论文部分内容阅读
作者采用经颈静脉肝内门腔内支架分流术(TIPSS)治疗12例门静脉高压症上消化道出血。其中6例同时经肝内门腔分流途径行食管胃底静脉硬化栓塞术(SEEV)。术后12例出血均立即停止。术后2例发生肝性脑病,4例因 TIPSS 分流通道狭窄、闭塞而发生再出血。4例中,3例经对肝内分流通道实施球囊扩张和/或置入另一组支架后再无出血发生。本组6例死亡,其死因分别为多器官衰竭、肝功能衰竭以及术后再出血。文中对 TIPSS 在门静脉高压症上消化道出血急诊救治中的价值进行了讨论。
The authors used transjugular intrahepatic portosystemic shunt (TIPSS) to treat 12 cases of portal hypertension with upper gastrointestinal bleeding. Among them, 6 cases underwent endoscopic esophageal and gastric venous shunt embolization (SEEV). All 12 cases of bleeding stopped immediately. Hepatic encephalopathy occurred in 2 cases after surgery, and in 4 cases, rebleeding occurred due to stenosis and occlusion of the TIPSS shunt channel. Of the 4 cases, 3 had no bleeding after balloon dilatation of the intrahepatic shunt and / or placement of another stent. The group of 6 deaths, the cause of death were multiple organ failure, liver failure and rebleeding. This article discusses the value of TIPSS in the emergency treatment of upper gastrointestinal bleeding in patients with portal hypertension.