杨宁介入医学网

门静脉高压症 （Portal hypertension,PH）是指门静脉压力的病理性升高,主要是由于慢性终末期肝病,导致肝血管阻力增强和门静脉系统充血所致。 肝硬化门静脉高压 （Crrhotic Portal Hypertension） 病因: 慢性病毒性肝炎、 酒精肝、 自身免疫性肝病(自免肝、PB...

由于门静脉系统解剖的特殊性，直接测定门静脉压力困难较大。 HVPG是指肝静脉楔压与自由压之差，测定HVPG相对容易，目前HVPG是国际公认反映门静脉压力的最佳指标。在行经颈静脉肝内门体分流术 (TIPS)治疗的门静脉高压患者中，发现HVPG与门静脉压力之间具有良...

无创检查 CSPH 临床显著门静脉高压 High-risk EV高风险食管静脉曲张 敏感性 特异性 敏感性 特异性 超声影像 40-70 ＞80 血小板计数 80 68 APRI 66 73 FibroTest 88 50 血小板/脾脏比值 85 66 肝脏硬度（LS） 87 85 86 59 脾脏硬度（SS） 98 74 83 57 肝硬度X...

临床征象与失血容量 临床征象 失血比例容积 无临床征象 15% 体位性低血压 20%-30% 仰卧位低血压 ＞40% 老年人的告诫 正常植物神经功能的缺失可能导致老年人最小失血性低血压；药物或心脏功能不佳需要防止失血心动过速。 休克分级...

Follow-up 1st Follow-up CT within three days after PARTO Thrombosis of the GV and portosystemic shunt Complete thrombosis of GV portosystemic shunts Small residual intramural GV (n=2) 2nd Follow-up CT (2-4 mon.) + 1st F/U Endoscopy Obliter...

contrast CT images：afferent vein Proximal part of afferent vein was identified on the fluoroscopy JVIR, 2015, Gwon DI et al JVIR, 2015, Gwon DI et al....

INTRODUCTION Gastric variceal bleeding Higher mortality and rebleeding rate Radiology, 2011, Saad WE et al. Treatment for gastric varices (GV) with portosystemic shunt Balloon-occluded retrograde transvenous obliteration (BRTO) Plug-assist...

Hepatic hypertrophy after balloonoccluded transvenous obliteration of gastric varices 背景1 经自发性胃肾分流经静脉硬化胃静脉曲张的BRTO技术是来自日本治疗胃静脉曲张或出血的特殊治疗手段 此手术增加门静脉到肝脏的血流: 加重门静脉高压 潜在改善肝...

BRTO for Gastric Varices [BRTV] Hirotas classification Downgrading (stepwise injection of EO, coiling, deeper into GRS, habitus change) [Collaterals] LIPV, PCV, (hemi) Azygos V, AscLV, Gonadal V, etc. [GR shunt] Single, Ring, Streaks [Irre...

BRTO: indications and treatment Authors: K. Kobayashi, S. Hirota, S. Yamamoto, S. Achiwa, M. Yamazaki, H. Maeda Abstract Content 1. Introduction: B- RTO (balloon- occluded retrograde transvenous obliteration) has developed in Japan since 1...