摘要
目的探讨经颈静脉肝内门体分流术(TIPS)联合AngioJet血栓清除装置治疗急性非肿瘤性肝硬化门静脉血栓(PVT)的安全性与有效性。方法回顾性分析9例接受TIPS联合AngioJet血栓清除装置治疗的急性非肿瘤性肝硬化PVT患者的临床与影像资料,分析其基线资料并观察术后即刻及术后6个月门静脉系统主干血栓的清除程度、治疗过程中并发症的发生情况及术后6个月支架通畅率等。结果9例患者均治疗成功。其中术后即刻门静脉系统主干血栓清除Ⅱ级6例(66.67%),Ⅲ级3例(33.33%)。术后7例出现血红蛋白尿,经水化、碱化尿液治疗1~2 d后恢复正常;穿刺点轻微渗血1例,加压包扎后止血;1例患者出现肝性脑病,经药物治疗后症状消失;均未发生肠坏死、消化道再出血等其他严重并发症。随访至6个月时支架均通畅,通畅率100.00%;门静脉系统血栓清除Ⅱ级4例(44.44%),Ⅲ级5例(55.56%),临床症状均未复发。结论TIPS联合AngioJet血栓清除装置治疗急性非肿瘤性肝硬化PVT是安全、有效的,值得临床推广。
Objective To explore the safety and effectiveness of transjugular intrahepatic portosystemic shunt(TIPS)combined with AngioJet thrombus remover for treating acute non-neoplastic portal vein thrombosis(PVT)in cirrhosis.Methods The clinical and imaging data of 9 patients with acute non-neoplastic PVT in cirrhosis,who received TIPS combined with AngioJet thrombus remover for treatment,were retrospectively analyzed.The baseline information was analyzed,and the clearance degree of main venous thrombosis immediately after operation and 6 months after operation,complications during the treatment,and the stent patency rate 6 months after operation were observed.Results All 9 patients were successfully treated,thereinto there were 6 cases(66.67%),whose clearance degree of main venous thrombosis expressed in grade Ⅱ immediately after operation,and 3 cases(33.33%)interpreted in grade Ⅲ of clearance degree of main venous thrombosis.A total of 7 cases occurred hemoglobinuria after operation,who returned to normal after the treatment of hydrates and alkalized urine 1-2 days;moreover,one case occurred slighter blood exudation at puncture point,which hemostasis after compression bandaging;furthermore,one patient occurred hepatic encephalopathy,whose symptoms disappeared after drug treatment;in addition,no serious complication including intestinal necrosis,alimentary rehemorrhage etc.occurred in all patients.The stents were unobstructed at 6 months of follow-up,with 100.00%patency rate.A total of 4 cases(44.44%)interpreted in grade Ⅱ of the clearance of portal vein system,and 5 cases(55.56%)in grade Ⅲ.No clinical symptom reoccurred.Conclusion TIPS combined with AngioJet thrombus remover for the treatment of acute non-neoplastic PVT in cirrhosis is safe and effective,which is worthy of clinical promotion.
作者
郑波
胡伟
张训
袁罡
徐燕能
罗建明
马小燕
张向琼
斯光晏
ZHENG Bo;HU Wei;ZHANG Xun;YUAN Gang;XU Yanneng;LUO Jianming;MA Xiaoyan;ZHANG Xiangqiong;SI Guangyan(Department of Interventional Clinic,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646600,Sichuan,China)
出处
《微创医学》
2022年第2期154-158,共5页
Journal of Minimally Invasive Medicine
