Morris C S, Najarian K E
Department of Radiology, Fletcher Allen Health Care, University of Vermont College of Medicine, Burlington, USA.
Am J Gastroenterol. 2000 Oct;95(10):2966-8. doi: 10.1111/j.1572-0241.2000.03211.x.
The efficacy of the transjugular intrahepatic portosystemic shunt procedure (TIPS) in controlling refractory hemorrhage from stomal varices at the mucocutaneous junction has been previously described, but the durability of this procedure for this indication is unknown. Conservative therapy may be unsuccessful in preventing recurrent hemorrhage. Some authors believe that portosystemic shunting is the treatment of choice for patients with bleeding stomal varices who are good surgical candidates, because of the low incidence of recurrent bleeding and the longest survival. We report the 39-month angiographic and hemodynamic follow-up, and the 48-month clinical follow-up of a patient with refractory hemorrhage from stomal varices and coexistent chronic portal vein occlusion successfully treated with a TIPS procedure.
经颈静脉肝内门体分流术（TIPS）在控制黏膜皮肤交界处吻合口静脉曲张所致难治性出血方面的疗效此前已有报道，但该手术用于此适应症的持久性尚不清楚。保守治疗在预防复发性出血方面可能并不成功。一些作者认为，对于吻合口静脉曲张出血且适合手术的患者，门体分流术是首选治疗方法，因为复发性出血的发生率低且生存期最长。我们报告了一例因吻合口静脉曲张难治性出血且并存慢性门静脉闭塞而成功接受TIPS手术治疗的患者的39个月血管造影和血流动力学随访结果，以及48个月的临床随访结果。
