Introduction to portal venography

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

mén jìng mài zào yǐng 2 English reference

portal phlebography

portal venography

portography

portophlebography

portovenography 3 Operation name

Portovenography 4 Indications

Portovenography is suitable for:

1. Liver cirrhosis and obstructive lesions of the intrahepatic and extrahepatic portal vein system.

2. Liver malignant tumors, understand the patency of the portal vein.

3. For unexplained upper gastrointestinal bleeding, learn about the portal vein.

4. Postoperative angiography of portal and systemic vein shunts to understand the condition of the portal vein.

5. Congenital diseases of the portal vein. 5 Contraindications

1. Allergy to contrast media and anesthetics.

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

3. Extreme weakness and severe coagulation dysfunction.

4. Local infection and high fever during 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.

(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 agent: organic iodine water preparation (40% to 76% ionic or non-ionic with corresponding concentration).

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

1. Splenic portal venography? Under the guidance of B-ultrasound, puncture the 8th to 10th intercostal space in the left midaxillary line, insert a needle into the spleen in the direction of the splenic hilum, and inject contrast agent after seeing blood return. Exposure imaging to demonstrate the portal vein through backflow of contrast material.

2. Hepatic portal venography? Under the guidance of B-ultrasound, the portal vein is punctured in the 8th to 10th intercostal space on the right mid-axillary line and the contrast agent is injected to expose the portal vein system after seeing the blood return.

3. Indirect portal venography? The Seldinger technique is used, percutaneous femoral artery puncture and cannulation is performed, celiac artery or splenic artery angiography is performed, and the portal vein is displayed through the backflow of splenic contrast agent.

4. Injection parameters? For splenic portal venography, the contrast agent dosage is 20 to 30 ml/time, and the injection flow rate is 5 to 8 ml/s; for hepatic portal venography, the contrast medium dosage is 18 to 25 ml/time, and the injection flow rate is The rate is 5-7ml/s; for indirect portal venography, the contrast agent dosage is 25-30ml/time, and the injection flow rate is 6-8ml/s.

5. Angiography ***? Orthotopic position, and oblique position if necessary.

6. Imaging procedure? 2 to 3 frames/s, injection delay 0.5s. Breath-hold exposure continued until the portal vein and its collateral circulation were displayed.

7. Postoperative extubation? After the angiography is completed, the catheter is pulled out, local compression is applied and then pressure bandage is applied.

8. Record? The photographer should 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 bed after surgery and observe the patient for complications caused by intubation and angiography.

5. When puncturing the liver and spleen, the patient must hold his breath to prevent the puncture needle from scratching the organs.

6. Prevent and treat the following complications

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