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目的 探讨和评价经颈静脉肝内门腔静脉分流术 (TIPS)治疗复杂型Budd Chiari综合征(BCS)并门脉高压的临床应用价值。方法 患者男 4例 ,女 1例 ,平均年龄 33岁 ,均有不同程度的食管胃底静脉曲张 ,4例有上消化道出血史 ,2例伴有腹水。经下腔静脉相当于右肝静脉开口部进针穿刺门脉行TIPS治疗。结果 5例均获成功。门脉压力由术前平均 (4 7± 1 3)kPa降至 (3 5± 1 5 )kPa(1kPa =7 5mmHg)。术后 2 4h 1例死于心肺衰竭 ;术后 3周 1例死于肝功能衰竭。另 3例平均随访6 4个月 ,肝功能均正常。 2例于术后 6、9个月均有分流道狭窄 ,并行二次介入治疗。结论 TIPS是解决复杂型BCS伴门脉高压的一种安全有效的治疗方法
Objective To investigate and evaluate the clinical value of transjugular intrahepatic portal venous bypass (TIPS) in the treatment of complex Budd Chiari syndrome (BCS) with portal hypertension. Methods There were 4 males and 1 females with a mean age of 33 years. All had esophageal and gastric varices in varying degrees, 4 had history of upper gastrointestinal bleeding and 2 had ascites. The inferior vena cava is equivalent to the opening of the right hepatic vein puncture needle TIPS treatment. Results 5 cases were successful. Portal pressure decreased from (47 ± 1 3) kPa preoperatively to (35 ± 1 5) kPa (1 kPa = 7 5 mmHg). 1 case died of cardiorespiratory failure 24 hours after operation; 1 case died of liver failure 3 weeks after operation. The other 3 cases were followed up for an average of 64 months, with normal liver function. Two cases had shunt stenosis at 6 and 9 months after operation, and the second interventional therapy was performed. Conclusion TIPS is a safe and effective treatment for complex BCS with portal hypertension