[1]吴瑕,徐克.改良式TIPS的解剖学基础研究[J].介入放射学杂志,2007,(05):316.
 WU Xia,XU Ke.Basic anatomic study of transjugular intrahepatic portosystemic shunt by direct transcaval approach[J].journal interventional radiology,2007,(05):316.
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改良式 TIPS 的解剖学基础研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年05期
页码:
316
栏目:
血管介入
出版日期:
2007-05-15

文章信息/Info

Title:
Basic anatomic study of transjugular intrahepatic portosystemic shunt by direct transcaval approach
作者:
吴瑕徐克
110001沈阳中国医科大学附属一院放射科
Author(s):
WU XiaXU Ke.
Department of Radiology,The First Affiliated Hospital of China Medical University,Shenyang110001,China
关键词:
门脉高压门体分流经肝段下腔静脉多层螺旋CT肝脏介入
分类号:
R735.7
文献标志码:
A
摘要:
目的探讨肝硬化门脉高压患者下腔静脉、肝静脉与门静脉三者之间的影像解剖学关系,评估改良式TIPS,即经肝段下腔静脉入路经颈静脉肝内门体分流术的安全性与可行性。方法64例临床证实的肝硬化患者,肝功能Child-Pugh B级40例,C级24例,行肝脏双期增强扫描后行CT多层面重组(MPR)及曲面重建(CPR)后处理,将测量所得数据进行配对t检验。结果Child-Pugh B级者肝段下腔静脉的长度与C级者相比前者较长(P<0.05)。以肝段下腔静脉穿刺点为A1,肝右静脉开口2cm处的穿刺点为A2,门静脉分叉部穿刺点为B1,门静脉右支开口2cm处的穿刺点为B2,A1B1线的长度与A2B1线的长度相比前者较短(P<0.05),A1B2线和A2B2线与B2点所在门静脉右支径线的夹角大小相比前者较小(P<0.05)。A1B1线和A1B2线分别与所在门静脉径线的夹角相比前者较大(P<0.05),A2B1线和A2B2线分别与所在门静脉径线的夹角相比前者较大(P<0.05)。结论从解剖学角度分析,改良式TIPS具备安全性及可行性,较传统TIPS术式还具有分流道走行顺畅,对血流动力学影响小的优点。

参考文献/References:

[1]Rossle M,Deibert P,Haag K,et al.Randomized trial of trans-jugular-intrahepatic portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding[J].Lancet,1997,349:1043-1049.
[2]Rossle M,Ochs A,Gulberg V,et al.A comparison of paracen-tesis and transjugular intrahepatic portosystemic shunting in patients with ascites[J].N Engl J Med,2000,342:1701-1707.
[3]Gines P,Vriz J,Calahorra B,et al.transjugular intrahepatic portosystemic shunting versus paracentesis plus refractory ascites in cirrhosis[J].Gastroenterology,2002,123:1839-1847.
[4]Michl P,Bilzer M,Waggershauser T,et al.Successful treatment of chronic Budd-Chiari syndrome with a transjugular intrahepatic portosystemic shunting[J].J Hepatol,2000,32:516-520.
[5]Perello A,Garcia-Pagan JC,Gilabert A,et al.TIPS is a useful longterm derivative therapy for patients with Budd-Chiari syndrome uncontrolled by medical therapy[J].Hepatology,2002,35:132-139.
[6]Brensing KA,Textor J,Perz J,et al.Long term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant cirrhotics with hepatorenal syndrome:a phaseⅡstudy[J].Gut,2000,47:288-295.
[7]Cabrera J,Maynar M,Granados R,et al.Transjugular intrahe-patic portosystemic shunt versus sclerotherapy in the elective treatment of variceal hemorrhage[J].Gastroenterology,1996,110:832-839.
[8]Camargo AM,Teixeira GG,Ortale JR.Anatomy of the ostia venae hepatic and the retrohepatic segment of the inferior vena cava[J].J Anat,1996,188(Pt1):59-64.
[9]Saxon RR,Keller FS.Technical aspects of accessing the portal vein during the TIPS procedure[J].J Vasc Interv Radiol,1997,8:733-744.
[10]《中华放射学杂志》编委会介入组.经颈静脉肝内门体静脉分流术临床技术指南[J].中华放射学杂志,2004,36:1329-1331.
[11]褚建国,孙晓丽,黄鹤,等.经肝段下腔静脉入路经颈静脉肝内门体分流术的适应证及解剖基础[J].介入放射学杂志,2004,13:15-18.

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备注/Memo

备注/Memo:
收稿日期:2006-10-23
更新日期/Last Update: 2007-05-15