本文選題：經頸靜脈肝內門體分流術 + 支架��； 參考：《中國介入影像與治療學》2017年02期

【摘要】：目的對比分析應用3種支架植入方式[裸支架、覆膜支架、雙支架(裸支架+覆膜支架)]行經頸靜脈肝內門體分流術(TIPSS)的分流效果、對肝功能的影響和中遠期通暢率。方法回顧性分析因肝硬化門靜脈高壓合并上消化道出血行TIPSS治療的178例患者的臨床資料,比較3種支架的臨床療效、肝功能恢復時間、術后1年一期和二期通暢率。結果 178例患者中,成功植入支架175例,成功率為98.31%(175/178),其中裸支架52例,覆膜支架52例,雙支架71例。所有患者的出血均得到控制。裸支架組、覆膜支架組、雙支架組肝功能恢復正常時間分別為(5.3±1.4)天、(9.8±1.7)天、(6.2±1.7)天,裸支架組和雙支架組與覆膜支架組的差異有統(tǒng)計學意義(P均0.01),裸支架組和雙支架組間差異無統(tǒng)計學意義(P0.05)。裸支架組、覆膜支架組和雙支架組1年一期通暢率分別為78.84%(41/52)、84.61%(44/52)、90.14%(64/71),兩兩比較差異均有統(tǒng)計學意義(P均0.01);1年二期通暢率均為100%。結論采用雙支架技術行TIPSS技術,對肝功能影響小,可提高中遠期通暢率,可作為Viatorr支架的替代選擇。
[Abstract]:Objective to compare and analyze the shunt effect of three stents (bare stents, covered stents, double stents (bare stents covered stents) with TIPSS), and the effect of TIPSSs on the liver function and the patency rate in the medium and long term. Methods the clinical data of 178 patients with portal hypertension complicated with upper gastrointestinal bleeding due to cirrhosis were analyzed retrospectively. The clinical effects of three stents, the recovery time of liver function, and the patency rate of one year and two stages after operation were compared. Results among 178 patients, 175 cases were stents successfully implanted, the success rate was 98.31% 17.5% 178%, including 52 cases of bare stents, 52 cases of covered stents and 71 cases of double stents. Bleeding was controlled in all patients. The recovery time of liver function in bare stent group, covered stent group and double stent group were 5.3 鹵1.4 days and 9.8 鹵1.7 days respectively. There was significant difference between bare stent group and double stent group and covered stent group (P < 0.01), but there was no significant difference between bare stent group and double stent group (P 0.05). The one-stage patency rates of bare stent group, covered stent group and double stent group were 78.84% and 84.61%, respectively, and the differences were statistically significant (P < 0.01). Conclusion double stent TIPSS technique has little effect on liver function and can improve the patency rate in medium and long term. It can be used as an alternative to Viatorr stent.
【作者單位】： 白求恩國際和平醫(yī)院放射科;
【分類號】：R657.3

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