[1]黄金旗,张庆贤,高晓杰,等.CT影像导引预穿刺塑形在TIPS术中的应用[J].介入放射学杂志,2023,32(01):63-67.
　HUANG Jinqi,ZHANG Qingxian,GAO Xiaojie,et al.Application of CT image-guided pre-puncture shaping technique in transjugular intrahepatic portosystemic shunt[J].journal interventional radiology,2023,32(01):63-67.
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CT影像导引预穿刺塑形在TIPS术中的应用()

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

卷:
32
期数:
2023年01
页码:
63-67
栏目:
临床研究
出版日期:
2023-02-13

文章信息/Info

Title:
Application of CT image-guided pre-puncture shaping technique in transjugular intrahepatic portosystemic shunt
作者:
黄金旗; 　张庆贤; 　高晓杰; 　陈　煌; 　郑景达
Author(s):
HUANG Jinqi;  ZHANG Qingxian;  GAO Xiaojie;  CHEN Huang;  ZHENG Jingda.
Department of Intervention and Vascular Surgery, Putian Municipal First Hospital, Putian, Fujian Province 351100, China
关键词:
【关键词】经颈静脉肝内门体分流术; 肝硬化; 门静脉穿刺; 预穿刺塑形
文献标志码:
A
摘要:
【摘要】　目的　探讨CT影像导引下预穿刺塑形在经颈静脉肝内门体分流术（TIPS）中的应用价值。方法　回顾性分析2019年1月至2021年6月在莆田市第一医院接受TIPS术治疗的56例肝硬化伴上消化道出血患者临床资料。借助术前CT影像显示的肝静脉和门静脉，设计肝静脉穿刺点（A点）、穿刺角度和方向、预期穿刺的门静脉靶点（B点），精确测量A、B点三维距离，并对穿刺针进行塑形。记录术中门静脉穿刺次数，观察术中和术后相关并发症。结果　56例患者穿刺次数为（1.68±1.32）次。穿刺1次成功40例（71.4%），2次成功8例（14.3%），4次成功2例（3.6%），4次仍未成功6例（10.7%），其中4例联合门静脉间接造影后穿刺成功，2例门静脉海绵样变患者结合经皮经肝门静脉穿刺并置入定位导管后穿刺成功。56例手术均取得成功，其中49例（87.5%）联合胃冠状静脉栓塞术。经肝右静脉穿刺50例（89.3%），经肝中静脉穿刺6例（10.7%）；穿刺门静脉右支47例（83.9%），穿刺门静脉左支9例（16.1%）。门静脉压由术前（39.46±7.09） cmH2O（1 cmH2O=0.098 kPa）改善至术后（24.95±3.41） cmH2O（t=17.726，P＜0.01）；门体静脉压差由术前（28.25±5.50） cmH2O改善至术后（16.13±4.32） cmH2O（t=20.017，P＜0.01）。未发生腹腔出血等严重并发症。结论　借助CT影像对TIPS穿刺针进行预穿刺塑形，穿刺成功率较高，值得临床推广应用。

参考文献/References:

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备注/Memo

备注/Memo:
（收稿日期：2021-11-12）
（本文编辑：边　佶）　　
更新日期/Last Update: 2023-02-13