目的探讨单导丝门静脉定位技术辅助经颈静脉肝内门体分流术(TIPS)中肝内门静脉穿刺的有效性和安全性。方法连续收集2017年1月至2018年8月因肝硬化门静脉高压症接受单导丝门静脉定位辅助TIPS治疗的12例患者临床资料。术前通过门静脉CTV评估门静脉解剖并预先选定肝内门静脉穿刺点。术中在彩色超声导引下采用21 G Chiba针经皮经肝穿刺肝内门静脉分支,引入0.014英寸导丝并将其远端置入脾静脉,再以导丝为靶向经肝静脉穿刺门静脉左支或右支主干,穿刺成功后完成后续TIPS操作;术毕拔除门静脉定位导丝,无需封堵穿刺道。观察评估门静脉穿刺次数、穿刺成功率及穿刺相关并发症。结果12例TIPS患者肝内门静脉穿刺均获成功。其中8例经Ⅲ段门静脉分支入路放置细导丝导向经肝静脉穿刺门静脉左支主干建立分流道,4例经Ⅷ段门静脉分支入路放置细导丝导向经肝静脉穿刺门静脉右支主干建立分流道。平均穿刺次数为(1.25±0.45)次(1~2次),术后患者均未出现门静脉穿刺相关并发症。结论采用单导丝定位门静脉辅助TIPS术中门静脉穿刺技术操作简便、安全有效,适用于TIPS分流道穿刺高风险患者。
OBJECTIVE: To observe the significant differences in the frequencies of the cytochrome P450 2D6 (CYP2D6) alleles in Chinese popoulations. METHODS: Tetra-primer polymerase chain reaction (PCR), allele specific amplific...
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OBJECTIVE: To observe the significant differences in the frequencies of the cytochrome P450 2D6 (CYP2D6) alleles in Chinese popoulations. METHODS: Tetra-primer polymerase chain reaction (PCR), allele specific amplification (ASA) PCR and multiplex long PCR were developed to detect the CYP2D6 alleles * 2, * 3, * 4, * 5, * 6, * 8, * 10 and * 14 in 223 subjects from Chinese mainland. RESULTS: The CYP2D6 * 5 allele was the most frequent poor metabolizer (PM) allele in Chinese (7.2%), followed by CYP2D6 * 14 (2.0%) which was only detected in orientals. There was only 0.2% CYP2D6 * 4, and no CYP2D6 * 3, * 6 and * 8 were detected. In contrast to the Caucasians, the most frequent allele in Chinese was the * 10 allele with a frequency of 51.6%. CONCLUSION: The frequencies of PM alleles, CYP2D6 * 5 and CYP2D6 * 14, were higher; but the frequency of CYP2D6 * 10 was lower in mainland Chinese population than that in other orientals.
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