经颈静脉肝内门体分流术治疗肝硬化门静脉高压患儿一例

doi:10.3877/cma.j.issn.2095-5782.2026.02.015

中华介入放射学电子杂志 ›› 2026, Vol. 14 ›› Issue (02) : 216 -218. doi: 10.3877/cma.j.issn.2095-5782.2026.02.015

病例报告

经颈静脉肝内门体分流术治疗肝硬化门静脉高压患儿一例

宋学栋¹, 夏杰军², 庞宁东², 刘国珩¹, 韦树长¹^,^†(

)

¹　545000　广西柳州，广州市妇女儿童医疗中心柳州医院介入血管瘤科
²　510623　广东广州，广州医科大学附属妇女儿童医疗中心介入血管瘤科

收稿日期:2025-08-12 出版日期:2026-05-25
通信作者: 韦树长

Transjugular Intrahepatic Portosystemic Shunt for the Treatment of Portal Hypertension in a Child with Cirrhosis: A Case Report

Xuedong Song¹, Jiejun Xia², Ningdong Pang², Guoheng Liu¹, Shuchang Wei¹^,^†()

¹ Department of Interventional Therapy and Vascular Anomalies, Liuzhou Hospital, Women and Children's Medical Center, Guangzhou Medical University, Liuzhou Guangxi 545000, China
² Department of Interventional Therapy and Vascular Anomalies, Women and Children's Medical Center, Guangzhou Medical University, Guangzhou Guangdong 510623, China

Received:2025-08-12 Published:2026-05-25
Corresponding author: Shuchang Wei

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8岁女性患儿，4月龄行肝肠吻合术，近1年反复3次消化道出血。计算机断层扫描证实肝硬化、脾大，胃镜示食管胃底静脉重度曲张。急诊行经颈静脉肝内门体分流术（transjugular intrahepatic portosystemic shunt，TIPS）：建立8 mm直径支架，门静脉压力由34 mmHg降至17 mmHg。术后72小时出血停止，超声复查支架通畅。TIPS术是儿童肝硬化门脉高压消化道出血的一种微创、安全、有效的治疗手段，能够快速有效地降低门静脉压力，改善消化道出血等症状，也可作为患儿肝移植前的过渡治疗，但其疗效仍需长期随访观察验证。

关键词: 经颈静脉肝内门体分流术, 儿童, 肝硬化, 胆道闭锁, 个案

An 8-year-old female child underwent hepatointestinal anastomosis at the age of 4 months and had 3 repeated gastrointestinal bleeding in the past 1 year. CT confirmed liver cirrhosis and splenomegaly, and gastroscopy showed severe varicose veins of the esophageal and gastric fundus. Emergency Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure: an 8 mm diameter stent was placed, reducing the portal vein pressure from 34 mmHg to 17 mmHg. Bleeding stopped 72 hours after surgery, and the stent was patented by ultrasound review. TIPS is a minimally invasive, safe and effective treatment method for portal hypertension gastrointestinal bleeding in children with cirrhosis, which can quickly and effectively reduce portal vein pressure, improve symptoms such as gastrointestinal bleeding, and can also be used as a transitional treatment before liver transplantation in children, but its efficacy still needs to be verified by long-term follow-up

Key words: Transjugular intrahepatic portosystemic shunt, Child, Cirrhosis, Biliary atresia, Cases

图1 经颈静脉肝内门体分流术简要过程图1A：RUPS-100穿刺系统从肝中静脉穿刺门静脉；图1B：造影导管至门脉主干造影，并测门静脉压力；图1C：球囊导管预扩张肝内穿刺道，植入8 mm × 60 mm 覆膜支架一枚；图1D：造影示支架通畅（侧位），再次测量门静脉压力较前明显下降。

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