腔静脉的

Methods:32 patients of TCPC were reviewed: the average age was 10 years,ranged from 5 to 24 years and the average weight was 28 kilogramme,ranged from 13 to 55 kilogramme.18 patients underwent lateral tunnel and 1 patient underwent extracardiac conduit TCPC with hypothermic cardiopulmonary bypass and heart arrest,and 10 patients were treated by extracardiac conduit technique with normothermic CPB and without heart arrest and 2 patients without CPB,and 1 patients underwent two-step operation.

回顾性分析32例全腔静脉肺动脉连接术患者的临床资料：年龄5～24岁，平均（10±5）岁，体重13～55 kg，平均（28±11） kg，病种包括单心室16例，右心室双出口并完全性心内膜垫缺损6例，完全性大动脉转位并完全性心内膜垫缺损3例，三尖瓣闭锁6例，二尖瓣闭锁1例。其中，在低温体外循环心脏停跳下18例行右房内侧隧道法，1例行心外管道法，常温体外循环心脏跳动下10例行心外管道法，非体外循环下2例行心外管道法，1例行分次全腔静脉肺动脉连接术。

In choracic region,the distance from the puncture point to the median line should not exceed 20 mm,the appropriate angle between the needle and sternum is about 10 degree.The appropriate puncture depth from left and from right is 40 mm and 50 mm separtely.

经皮穿刺胸腺时为防止伤及左头臂静脉、上腔静脉以及胸膜腔，在颈部可在第3～4气管软骨环的下方进针；在胸部，沿胸骨后方上翘10°左右的角度穿入胸腺，距正中线左右不超过20 mm处进针，穿刺深度左侧40 mm，右侧50 mm为宜。

And There was no serious complication;②In the course ofinterventional therapy, Direct portal vein angiography demonstrated vena coronaria ventriculi(100%)andgastricveins(65.26%)andvenagastricaposterior38.43%, Angiography demonstrated venacoronariaventriculi communicate esophagus varicose veins, gastric veins and vena gastrica posterior communicategastric varicose veins. vena coronaria ventriculi had only a small percentage of double vein, about30.57%. The sites of vena coronaria ventriculi arising from the portal vein, splenic vein, portosplenic junction, were found in 52.06%、27.39%、20.55% respectively.③12 extrahepaticprotosystemic shunts were found in these patients. Include gastro-nephrosshuntof 3 cases, 7 caseswere splenetic- nephros shunt and 2 cases shown recanalization of umbilical vein .④The averageportal pressure before and after the procedure were 3.87±1.82kPa and 3.64±1.14kPa in 73patients, but to the time of rebleeding, it was 3.96±0.23kPa in the 11 cases.⑤There werethree kinds of variceal outcome: disappearance (54,low degree (19).⑥Spearman logisticanalyse and ANOVAtest shown liver function class, variceal degree of the splenic necrosis area,the blood direction in portal vein before operation and remain small collateral routes were thesignificant factors concerning outcome of varices.⑦The bleeding volume and portalhypertensive gastropathy are main risk factors of rebleeding.⑧The course of livercirrhosis is the risk factor of survival and extrahepatic portosystemic shunt , fine varices are thebeneficial factors to survival.⑨During all cases'followed-up data, the 1, 2, 3, 4, 5 yearcumulative survival rates and rebleeding rates were 17.81%, 28.77%, 38.36%, 43.84%, 47.95%and93.15%,91.78%,86.30%,83.56%,80.82%respectively. Conclusion The interventional disconnection treatment for liver cirrhosis and portalhypertension was designed suitability. It rapidlycontrol bleeding,butpressure of portal vein was notobvious high, perfusion was not low .it was compared with surgery therapeutic that interventionaldisconnection treatment was safe and had a significant clinical effect to hemorrhage and preventfrom rebleeding.

结果：①术后一过性发热62例(84.9%)，腹痛腹胀48例(65.8%)是介入断流术常见的并发症，未发生严重并发症；②门静脉造影显示胃冠状静脉、胃短静脉和胃后静脉的曲张分流的出现率是100%、65.26%和38.34%；显示食管静脉曲张主要由胃冠状静脉供血，胃静脉曲张主要由胃短静脉和胃后静脉供血；胃冠状静脉大多数为单支，少数为双支，其双支的出现率分别为30.57%；胃冠状静脉开口于门静脉主干的为52.06%，开口于脾静脉主干的为27.39%和开口于门脾静脉交汇处的为20.55%；③发现胃肾分流3例，脾肾分流7例、腹膜后门腔静脉分流2例，以及CTA检查发现脐静脉开放者2例；④73例患者介入断流术前和术后平均自由门静脉压力分别为3.87±1.82kpa和3.64±1.14kpa，前后比较存在显著性差异；11例再次介入手术患者的术前、术后和复发后的自由门静脉压力分别为4.02±0.24kpa、3.82±0.25kpa和3.93±0.23kpa ，前后比较发现首次术前与术后存在显著性差异，首次术前和复发出血术前门静脉压力比较无显著性差异；⑤介入术后复查曲张静脉转归基本消失54例，轻度19例；⑥Spearman相关分析和Logistic多因素回归分析，肝功能分级、静脉曲张程度、门脉血流方向和残存小侧支四个因素对曲张静脉转归有影响；Spearman相关分析和Logistic多因素回归分析门脉高压性胃病和出血量等因素对复发出血时间有影响；⑦COX回归分析，门体分流和曲张静脉转归两个因素对术后生存有影响；⑧术后随访6-70月，1、2、3、4、5年的累计复发出血率和累计生存率分别为17.81%、28.77%、38.36%、43.84%、47.95%和93.15%、91.78%、86.30%、83.56%、80.82%；结论：介入断流术治疗门脉高压食管胃底静脉曲张有独特的优点，可以快速直接控制曲张静脉出血而门静脉压力无显著增高，保证了肝脏灌注；与外科分流术相比适应证广、损伤轻、术后恢复快，不易遗漏曲张静脉；肝功能分级、曲张静脉程度、门脉血流方向和残存侧支血管对食管胃曲张静脉转归有影响；门脉高压性胃病对复发出血时间有影响；门体分流和曲张静脉转归对生存时间有影响。

The mono directional Glenn operation ( n =7) was performed by side to side anastomosis of superior vena cavae with right pulmonary artery with a beating heart supported by cardiopulmonary bypass.

3例双向 Glenn手术，上腔静脉与右肺动脉进行端侧吻合，上腔静脉近心端予以缝闭。手术结果，单向 Glenn手术患者，术后动脉血氧饱和度由术前的 5 0 %～ 6 0 %提高至术后的 70 %～ 80 %。

According to venography or surgery,the sensitivity and specificity of 3D DCE MRA in the diagnosis of abnormalities of vena cava were both 100%.In addition,it had advantages regarding demonstration of extravascular lesions and multiplanar capabilities.

以常规腔静脉造影和手术为标准，3D DCE MRA显示腔静脉病变的敏感性和特异性都为100%，另外它还具有能同时显示血管外病灶和多方位显示病变等优点。

Methods Twenty-five cases of giant PLCs, with a mean diameter of 14.78cm, were evaluated. All of the tumors involved the main hepatic veins and /or retrohepatic vena cava. Before resection the tumor was fully exposed and an occluding tape, when neccessary, was placed around the vena cava.

25例累及第二第三肝门的肝癌，平均肿瘤直径14.78cm，分别压迫主要肝静脉根部或/和肝后腔静脉；进腹充分暴露肿瘤后在间歇性第一肝门阻断下切除肿瘤，切肝前根据需要预置腔静脉阻断带备用。

Methods Twenty-five cases of giant PLCs, with a mean diameter of 14.78cm, were evaluated. All of the tumors involved the main hepatic veins and /or retrohepatic vena cava. Before resection the tumor was fully exposed and an occluding tape, when neccessary, was placed around the vena cava. The hepatectomies were performed under intermittent portal triad clamping.

25例累及第二第三肝门的肝癌，平均肿瘤直径14.78cm，分别压迫主要肝静脉根部或/和肝后腔静脉；进腹充分暴露肿瘤后在间歇性第一肝门阻断下切除肿瘤，切肝前根据需要预置腔静脉阻断带备用。

Vena orbitalis posterior plexus blood collection method, Exsanguinated before the inferior vena cava blood(Around the trachea to the needle into the subclavian), cardiac puncture blood collection methods(To the left oblique line to the right into the needle enter the subcutaneous on the fourth and firth rib), femoral artery and venous blood sampling means(enter injector orientation to heart proximal femoral artery and venous in 1～3 mm) and tail end approach were used in 5 groups respectively.

眼眶后静脉丛的采血法，前腔静脉采血（靠近气管至锁骨窝处进针），心脏穿刺采血法（倒数第4～5肋间刺入），股动静脉采血法（在股动静脉处向心端1～3mm处为最佳穿刺点）和尾尖采血方法。

Vena orbitalis posterior plexus blood collection method,Exsanguinated before the inferior vena cava blood(Around the trachea to the needle into the subclavian),cardiac puncture blood collection methods(To the left oblique line to the right into the needle enter the subcutaneous on the fourth and firth rib),femoral artery and venous...

眼眶后静脉丛的采血法，前腔静脉采血(靠近气管至锁骨窝处进针)，心脏穿刺采血法(倒数第4~5肋间刺入)，股动静脉采血法(在股动静脉处向心端1~3 mm处为最佳穿刺点)和尾尖采血方法。

Inferior vena cava is the largest vein in human body , wider than the hepatic vein, so some researchers propose direct intrahepatic portacaval shunt to lead some portal blood flow directly into vena cava, hoping to obtain more stable bypass.

DIPS术是在肝内门静脉与肝后段下腔静脉之间建立肝内分流，将部分门静脉血液直接分流入粗大的下腔静脉，它扩大了介入性门腔分流的适应症，可使部分难以实施TIPS术的患者也能做介入性门腔分流，成为介入性门腔分流的新热点。

I didn't watch TV last night, because it .

昨晚我没有看电视，因为电视机坏了。

Since this year, in a lot of villages of Beijing, TV of elevator liquid crystal was removed.

今年以来，在北京的很多小区里，电梯液晶电视被撤了下来。