Wang Y, Xu W, Xu H, Zu M H
Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China.
Zhonghua Gan Zang Bing Za Zhi. 2019 Oct 20;27(10):777-781. doi: 10.3760/cma.j.issn.1007-3418.2019.10.008.
To investigate the safety, feasibility, and preliminary clinical experience of ultrasonic guided percutaneous portal vein punctures combined bi-directional angiography in the treatment by transjugular intrahepatic portosystemic shunt(TIPS). From January 2016 to June 2018, 15 patients with TIPS from our hospital who were treated by ultrasonic guided percutaneous portal vein punctures combined with bi-directional angiography were enrolled,and were recruited as experimental group. During the same period, 30 patients who were treated by TIPS combined with traditional methods were enrolled, and were recruited as control group. There was no statistical difference in baseline characteristics between the two groups ( > 0.05). The portal pressure difference in preoperative and postoperative, the fluoroscopy time, the number of puncture needles and complications were recorded. After treatment, the patients were followed up through outpatient service or telephone method. The technical success rate was 100% in experimental group, and 96.7% in control group. In the experimental group, number of percutaneous transhepatic portal vein puncture by needle was 1-3 (average, 2.13 ± 0.74), and the number of portal vein puncture needles in the control group were 1-11 (average, 4.16 ± 2.13). The number of puncture needles in the experimental group were significantly decreased than in the control group ( < 0.001). In the experimental group, the fluoroscopy time was 18 ~ 46 (average 29.64 ± 8.79) minutes. In the control group, the fluoroscopy time was 12 ~ 150 (average 44.57 ± 26.84) minutes.The fluoroscopy time was significantly reduced in the experimental group compared with the control group( = 0.023). Ultrasound-guided portal vein combined with bidirectional angiog-raphy is safe, feasible, and reliable in the treatment by TIPS. Compare with traditional TIPS, it can reduce the fluoroscopy time, the number of puncture needles and the liver injury.
探讨超声引导下经皮门静脉穿刺联合双向血管造影在经颈静脉肝内门体分流术（TIPS）治疗中的安全性、可行性及初步临床经验。选取2016年1月至2018年6月在我院接受超声引导下经皮门静脉穿刺联合双向血管造影治疗的15例TIPS患者作为实验组。同期选取30例采用传统方法治疗的TIPS患者作为对照组。两组基线特征差异无统计学意义（>0.05）。记录术前、术后门静脉压差、透视时间、穿刺针数及并发症情况。治疗后通过门诊或电话方式对患者进行随访。实验组技术成功率为100%，对照组为96.7%。实验组经皮经肝门静脉穿刺针数为1～3针（平均2.13±0.74针），对照组门静脉穿刺针数为1～11针（平均4.16±2.13针）。实验组穿刺针数明显少于对照组（<0.001）。实验组透视时间为18～46分钟（平均29.64±8.79分钟）。对照组透视 time was 12～150分钟（平均44.57±26.84分钟）。实验组透视时间较对照组明显缩短（=0.023）。超声引导下门静脉联合双向血管造影在TIPS治疗中安全、可行、可靠。与传统TIPS相比，可减少透视时间、穿刺针数及肝损伤。
