Department of Radiology, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322-1059, USA.
AJR Am J Roentgenol. 2012 Oct;199(4):W449-53. doi: 10.2214/AJR.12.9203.
Many patients with cirrhotic effusions in the peritoneal and pleural spaces lead a difficult existence. In addition to their decreased mobility and physical discomfort, they spend hours in the hospital or an outpatient facility undergoing peritoneal and pleural drainage. Liver transplantation is the ultimate solution for those with cirrhotic effusions refractory to medical management; however, most are on a long waiting list, forcing them to undergo a year or more of percutaneous centesis. Transjugular intrahepatic portosystemic shunts offer relief to those with cirrhotic ascites but at the cost of accelerated hepatic failure and hepatic encephalopathy. This article will review the development of the peritoneovenous and pleurovenous shunt, discuss reasons for its loss of favor, and suggest its current role in the armamentarium of the interventional radiologist.
Peritoneovenous and pleurovenous shunt creation is a procedure that has the potential to significantly improve the quality of life of the patient by controlling the fluid collections, reducing dependence on frequent drainage procedures, improving renal function, and reducing protein loss.
许多患有肝源性浆膜腔积液的患者生活艰难。除了活动受限和身体不适外，他们还需要在医院或门诊设施中花费数小时进行腹腔和胸腔引流。肝移植是治疗对药物治疗无反应的肝源性浆膜腔积液患者的最终方法；然而，大多数患者都在等待名单上，这迫使他们进行一年或更长时间的经皮穿刺。经颈静脉肝内门体分流术可缓解肝硬化性腹水患者的症状，但代价是加速肝衰竭和肝性脑病。本文将回顾腹膜静脉和胸膜静脉分流术的发展，讨论其失宠的原因，并提出其在介入放射学家治疗手段中的当前作用。
腹膜静脉和胸膜静脉分流术的创建是一种有潜力的治疗方法，可以通过控制液体积聚、减少对频繁引流程序的依赖、改善肾功能和减少蛋白质丢失，显著提高患者的生活质量。
