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消化内科成功救治1例门静脉海绵样变合并急性上消化道大出血患者 2020.05.29

JINRI,XIAOHUANEIKELUOXUEFENGFUJIAOSHOUWEIYILIJIXINGSHANGXIAOHUADAODACHUXUEDEMENJINGMAIHAIMIANYANGBIANHUANZHECHENGGONGSHISHIJIZHENJINGJINGJINGMAIGANNEIMENTIFENLIUSHU(TIPS)。CICIJIZHENTIPSZHILIAOMENJINGMAIQUANCHENGBISAIBANHAIMIANYANGBIANHUANZHE,SHIXIAOHUAJIERUTUANDUIZAIFUZA、KUNNANMENJINGMAIGAOYAJIERUZHILIAODEYICIXINDECHENGGONGTUPO。

GAIHUANZHE64SUI,FAXIANYIGANGANYINGHUA17NIAN,WEIGUILVZHILIAO,8NIANQIANCENGXINGPIQIECHUSHU。RUYUANQIAN3TIANNEIFANFUFASHENGSHIYUCIOUXUE、HEIBIAN,DANGDIYIYUANZHILIAOHOURENGCUNZAIHUODONGXINGCHUXUE,SUIJINGJIZHENKESHOURUXIAOHUANEIKE。RUYUANHOUDI2TIANHUANZHEZAICIDALIANGOUXUE,CHUXIANSHIXUEXINGXIUKE,XINLV130-160CI/FEN,XUEYA70/40mmHg,XUEHONGDANBAIJIN49.2g/L,LIJIJIYUSANQIANGERNANGGUANYAPOJISHUXUE、BUYEDENGZHILIAO。JIEHEHUANZHEYUANWAIWEIJINGJIANCHA,HUANZHEXIAOHUADAOCHUXUEKAOLVWEISHIGUANJINGMAIQUZHANGPOLIECHUXUE,JINGZONGHOU,CHENBIN、LUOXUEFENGYISHENGNIWEIHUANZHEXINGJIZHENTIPS。

HUANZHESHANGFUBUZENGQIANGCTTISHIMENJINGMAIZHUGANJIGANNEIMENMAIFENZHI、CHANGXIMOSHANGJINGMAIQUANCHENGBISAI,MENJINGMAIHAIMIANYANGBIAN,QIEGANDONGMAIMINGXIANDAICHANGZENGCU。CHANGGUIFUZHUTIPSCHUANCIDEMENJINGMAIXIANYINGJISHUJUNWUFAXIANSHIGANNEIMENJINGMAIXITONG,TIPSJISHUNANDUDA,CHUANCIFENGXIANGAO,MENJINGMAIHAIMIANYANGBIANYECENGBEISHIWEITIPSDEJINQU。LUOXUEFENGFUJIAOSHOUYIJUMENJINGMAI、GANDONGMAIXIANGDUIJIEPOUWEIZHI,DAZHIGUJIBISAIDEGANNEIMENMAIFENZHIZAIXXIANYINDAOXIA“MANGCHUAN”,CHUANCIRUMENJINGMAIXUESHUANHOUZAINIXIANGKAITONGBISAIDUAN,BUDAOYIGESHIHOUJIUSHUNLIWANCHENGTIPS,CHENGGONGZHIRUZHIJIA,SHUHOUFENLIUDAOTONGCHANG。SHUHOUHUANZHEXIAOHUADAOCHUXUETINGZHI,WEICHUXIANGANGONGSUNHAI、GANXINGNAOBINGDENGBINGFAZHENG,YISHUNLICHUYUANGUILVSUIFANG。

TIPS术前门静脉造影显示肠系膜上静脉、门静脉主干、肝内门脉分支全程闭塞伴门静脉海绵样变,大量侧枝循环显影

MENJINGMAIQUANCHENGBISAIBANHAIMIANYANGBIANHUANZHEWUFATONGGUOCHANGGUIYINGXIANGYINDAOJISHUXIANSHIMENJINGMAIXITONG,CHUANCINANDUJIDA,SHAOYOUBUSHENHENRONGYIFASHENGFUQIANGCHUXUE,ZHANGQIYILAIBEISHIWEITIPSJINQU,MEIGUOGANBINGXUEHUITIPSLINCHUANGYINGYONGZHINANJIANGQILIEWEIJISHUJINJIZHENG。

MENJINGMAICHUANCIDAOHANGSHITIPSDEGUANJIANHUANJIE,LUOXUEFENGFUJIAOSHOUTUANDUIZAICHANGGUITIPSDEJICHUSHANG,CHUANGXINHEGAILIANGLEYIXILIETIPSYINDAOJISHU,ZHIDAOGUONEIBUTONGCENGJIYIYUANKAIZHAN,XIANGGUANYANJIUYIZAI《European Radiology》《Cardiovascular and Interventional Radiology》、《American Journal of Roentgenology》DENGSCISHOULUZAZHIFABIAO,DADAOGUOJIXIANJINSHUIPING。

作者:消化内科 编辑:史杰蔚 周亮 来源:消化内科
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