Introduction to hepatic venography

Contents 1 Pinyin 2 English reference 3 Operation name 4 Indications of hepatic venography 5 Contraindications of hepatic venography 6 Preparation 7 Method 8 Precautions 1 Pinyin

gān jìng mài zào yǐng 2 English reference

hepatic venography

hetophlebography 3 Procedure name

Hepatic venography 4 Indications

Hepatic venography is suitable for:

1. Buca syndrome.

2. Portal hypertension.

3. Before transjugular intrahepatic portosystemic stent shunt surgery. 5 Contraindications

1. Allergy to contrast media and anesthetics.

2. Severe heart, liver, kidney dysfunction and other serious systemic diseases.

3. Those with extreme weakness and severe coagulation dysfunction.

4. People with local infection and high fever due to puncture. 6 Preparation

1. Patient preparation

(1) Explain the purpose of imaging and possible complications and accidents to the patient and family members, and sign an imaging agreement.

(2) Explain the angiography process and precautions to the patient to eliminate concerns and seek cooperation during the operation.

(3) Check heart, liver, kidney function, as well as blood routine and coagulation time.

(4) Necessary imaging examinations, such as B-ultrasound, CT, etc.

(5) Necessary treatment of iodine and anesthetics shall be carried out in accordance with the provisions of the Pharmacopoeia.

(6) Do not eat or drink 4 hours before surgery. Empty the bowels and bladder and teach the patient to hold their breath.

(7) Routine skin preparation is required at the puncture site, and sedatives are given if necessary.

(8) Establish intravenous channels to facilitate intraoperative medication and rescue.

2. Equipment preparation

(1) Cardiovascular X-ray machine and its ancillary equipment.

(2) Sterilization package for imaging surgical instruments.

(3) Puncture and intubation equipment, such as puncture needles, introducer sheaths, catheters and guide wires.

(4) Pressure syringe, its syringe and connecting tube.

3. Drug preparation

(1) Contrast agents include organic iodine water preparations (40% to 76% ionic or non-ionic at corresponding concentrations).

(2) Anesthetics, anticoagulants and various rescue drugs. 7 Methods

1. Hepatic vein wedged catheter angiography, that is, wedged method. The catheter is selectively inserted into the hepatic vein via femoral or jugular vein puncture.

2. Hepatic vein free catheter angiography, that is, the free catheter method. The femoral vein or jugular vein is punctured, and the catheter is placed into the larger hepatic vein, or a multi-hole catheter is selectively inserted into the hepatic vein.

3. Block hepatic venography, that is, blocking method. Through femoral vein or jugular vein puncture, a catheter with a capsule is selectively inserted into the hepatic vein, and 1 to 2 ml of liquid or gas is injected into the capsule to block the blood flow.

4. Percutaneous puncture liver parenchyma angiography, that is, liver puncture method. Puncture the liver in the 8th to 10th intercostal space under the right armpit and insert the catheter into the hepatic vein.

5. Injection parameters include contrast agent dosage of 8 to 10 ml/time and injection flow rate of 2 to 3 ml/s.

6. The angiography *** is in the upright position, and if necessary, in the oblique position.

7. The imaging program is 2 to 3 frames/s, and the injection delay is 0.5s. Breath-hold exposure to display the hepatic veins and their collateral circulation.

8. After the angiography is completed, pull out the catheter, apply local compression and then apply pressure bandage.

9. The photography technician will carefully fill in the relevant items and technical parameters of the inspection application form and sign it. 8 Precautions

1. Understand the indications and contraindications.

2. Make preparations before surgery.

3. Closely observe the patient’s reaction during the operation.

4. Rest in the right decubitus position after surgery, and observe the patient for complications caused by intubation and angiography.

5. Instruct the patient to hold his breath during percutaneous liver puncture to prevent liver scratches and massive bleeding.

6. Prevent and treat the following complications

(1) Complications of puncture and cannulation include temporary arterial spasm, local hematoma, pseudoaneurysm, arteriovenous fistula, and catheter artery Internal fracture, intimal arterial dissection, atherosclerotic plaque shedding, blood vessel rupture, cerebral vascular thrombosis and air embolism, etc.

(2) Complications of contrast media include shock, convulsions, epilepsy, cerebral edema, laryngeal edema, laryngeal or (and) bronchospasm, pulmonary edema, acute renal failure, etc.

(3) The splenic capsule is torn and bleeding, and the organs around the spleen (liver, kidney, colon, etc.) are stabbed.

(4) Pneumothorax occurs.