经颈静脉肝内门体分流术用于门静脉肿瘤血栓形成继发门静脉高压的姑息治疗。
Transjugular intrahepatic portosystemic shunt for palliative treatment of portal hypertension secondary to portal vein tumor thrombosis.
作者信息
Jiang Zai-Bo, Shan Hong, Shen Xin-Ying, Huang Ming-Sheng, Li Zheng-Ran, Zhu Kang-Shun, Guan Shou-Hai
机构信息
3rd Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China.
出版信息
World J Gastroenterol. 2004 Jul 1;10(13):1881-4. doi: 10.3748/wjg.v10.i13.1881.
AIM
To evaluate the palliative therapeutic effects of transjugular intrahepatic portosystemic shunt (TIPS) in portal vein tumor thrombosis (PVTT) complicated by portal hypertension.
METHODS
We performed TIPS for 14 patients with PVTT due to hepatocellular carcinoma (HCC). Of the 14 patients, 8 patients had complete occlusion of the main portal vein, 6 patients had incomplete thrombosis, and 5 patients had portal vein cavernous transformation. Clinical characteristics and average survival time of 14 patients were analysed. Portal vein pressure, ascites, diarrhoea, and variceal bleeding and circumference of abdomen were assessed before and after TIPS.
RESULTS
TIPS was successful in 10 cases, and the successful rate was about 71%. The mean portal vein pressure was reduced from 37.2 mmHg to 18.2 mmHg. After TIPS, the ascites decreased, hemorrhage stopped and the clinical symptoms disappeared in the 10 cases. The average survival time was 132.3 d. The procedure failed in 4 cases because of cavernous transformation in portal vein and severe cirrhosis.
CONCLUSION
TIPS is an effective palliative treatment to control hemorrhage and ascites due to HCC complicated by PVTT.
目的
评估经颈静脉肝内门体分流术（TIPS）对门静脉癌栓（PVTT）合并门静脉高压的姑息性治疗效果。
方法
对14例因肝细胞癌（HCC）导致PVTT的患者实施TIPS。14例患者中，8例患者门静脉主干完全闭塞，6例患者血栓形成不完全，5例患者存在门静脉海绵样变性。分析14例患者的临床特征及平均生存时间。在TIPS术前及术后评估门静脉压力、腹水、腹泻、静脉曲张出血及腹围。
结果
10例TIPS手术成功，成功率约为71%。门静脉平均压力从37.2 mmHg降至18.2 mmHg。TIPS术后，10例患者腹水减少、出血停止且临床症状消失。平均生存时间为132.3天。4例手术失败，原因是门静脉海绵样变性及严重肝硬化。
结论
TIPS是控制HCC合并PVTT所致出血和腹水的一种有效姑息性治疗方法。
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