CAJ | 학술논문

目的：评价选择门静脉左支作为经颈静脉肝内门腔静脉支架分流术（ TIPS）分流支的临床意义。方法1993年7月至2013年7月，空军总医院共对5673例患者行TIPS，其中4331例有目的地选择肝内门静脉左支作为穿刺靶点，行经颈静脉肝内门静脉左支门腔分流术（ TILPS）建立门腔分流道，避开富含营养、毒素的门静脉右支血液。肝实质通道用8 mm直径球囊扩张，限制分流口径。结果所有患者术后5年内无一例发生肝性脑病。随访期间全部TILPS术后患者连续5年随访造影未出现支架分流道内狭窄。结论选择门静脉左支作为门腔静脉分流支，可以显著降低肝性脑病发生率，对保护肝功能、提高分流道远期开通率具有重要的临床意义。
목적：평개선택문정맥좌지작위경경정맥간내문강정맥지가분류술（ TIPS）분류지적림상의의。방법1993년7월지2013년7월，공군총의원공대5673례환자행TIPS，기중4331례유목적지선택간내문정맥좌지작위천자파점，행경경정맥간내문정맥좌지문강분류술（ TILPS）건립문강분류도，피개부함영양、독소적문정맥우지혈액。간실질통도용8 mm직경구낭확장，한제분류구경。결과소유환자술후5년내무일례발생간성뇌병。수방기간전부TILPS술후환자련속5년수방조영미출현지가분류도내협착。결론선택문정맥좌지작위문강정맥분류지，가이현저강저간성뇌병발생솔，대보호간공능、제고분류도원기개통솔구유중요적림상의의。
Objective To evaluate clinical significance of transjugular intrahepatic left branch of portal vein portosystemic shunt ( TIPS) .Methods A total of 5673 patients underwent TIPS in our department from July 1993 to July 2013.The left branch of portal vein was punctured purposively follow by creation of TILPS in 4331 patients to keep the right branch of portal vein blood that contain nutrition and toxin away . Results There was no case of hepatic encephalopathy occurred in all patients during the postoperative 5 years.There was no narrow in the stent shunt or passage at follow-up angiography during the five years . Conclusion Selective left portal vein puncture as a portosystemic shunt branch can reduce the incidence of hepatic encephalopathy significantly .The protection of liver function and improved long-term shunt patency has important clinical significance .