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目的探讨肝实质段腹膜支架在颈静脉肝内门体分流术(TIPS)中的应用。方法选取该院因门脉高压症与肝硬化造成的消化道出血患者24例,所有患者均予以TIPS治疗。对比测量门体静脉压力梯度值(PSG)在分流前后的变化,并对其临床疗效、安全性和可行性予以评价。结果 24例患者手术均成功,分流后PSG低于分流前,差异有统计学意义(P<0.05);术后发生近期阶段死亡1例。结论采用组合支架能准确定位肝实质分流道,在操作上使精确放置覆膜支架相对简单,在一定程度上能对PSG的下降程度予以调控。
Objective To investigate the application of peritoneal stents in the hepatic parenchyma in the hepatic portal shunt (TIPS). Methods Twenty-four patients with gastrointestinal bleeding caused by portal hypertension and cirrhosis were selected. All patients were treated with TIPS. The changes of portal pressure gradient (PSG) before and after shunting were compared and the clinical efficacy, safety and feasibility were evaluated. Results All the 24 cases were operated successfully. The PSG after the shunt was lower than that before shunt. The difference was statistically significant (P <0.05). One patient died in the short term after operation. Conclusion The combination stent can accurately locate the shunt of hepatic parenchyma, and it is relatively easy to operate and accurately place the stent graft. To a certain extent, the degree of decrease of PSG can be regulated.