Transjugular intrahepatic portal shunt in the treatment of portal hypertension due to cirrhosis: single center experience
Transjugular intrahepatic portal shunt in the treatment of portal hypertension due to cirrhosis: single center experience
复制标题
经颈静脉肝内门静脉分流术治疗肝硬化门脉高压：单中心经验
DOI：
10.1186/s12893-019-0659-5
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发表时间：
2019-12-12
期刊：
影响因子：
1.9
通讯作者：
Zhang，Xiaomei
中科院分区：
文献类型：
--
作者：
Chen，Yun;Qiu，Hanyu;Zhang，Xiaomei
目的探讨经颈静脉肝内门静脉分流术（TIPS）治疗肝硬化门静脉高压的临床疗效。方法选取2014年1月至2017年6月住院的肝硬化门脉高压合并食管胃静脉曲张出血患者71例，采用TIPS治疗。比较TIPS前后门静脉压及血清生化指标的变化，计算再出血率、腹水发生率、并发症及生存率。结果71例肝硬化门静脉高压症患者（男/女47/24，年龄29-77岁，平均48.9±9.8岁）接受TIPS治疗。TIPS的成功率为93%（66/71）。66例患者随访1 ~ 24个月（平均12.5±7个月），存活61例，死亡5例。门静脉压力由40.48±3.15 cmH2O降至23.59±4.41 cmH2O （P< 0.05）。随访期间肝性脑病发生率为12.1%，再出血发生率为18.2%，支架功能障碍4例，其中裸支架1例，双支架3例。结论tips可降低门静脉压力，明显减轻腹水，是治疗肝硬化门静脉高压并发症的有效方法。TIPS术后肝功能短期受损，中期无明显影响。
AimTo investigate clinical efficacy of transjugular intrahepatic portal shunt (TIPS) for the treatment of cirrhotic portal hypertension.Methods71 cases of patients with cirrhotic portal hypertension and esophageal and gastric variceal bleeding hospitalized from January 2014 to June 2017 were enrolled and treated with TIPS. The change of portal pressure and serum biochemical indexes before and after TIPS were compared, and re-hemorrhage rate, ascites incidence, complications, and survival rate were calculated.Results71 patients (male/female 47/24, aged 29–77 years, average 48.9 ± 9.8 years) with cirrhotic portal hypertension received TIPS. The success rate of TIPS was 93% (66/71). During 1–24 months (mean 12.5 ± 7 months) follow-up of 66 patients, 61 cases survived and 5 cases died. The portal pressure decreased significantly from 40.48 ± 3.15 cmH2O to 23.59 ± 4.41 cmH2O after TIPS (P< 0.05). During the follow-up, the incidence of hepatic encephalopathy was 12.1%, the incidence of re-hemorrhage was 18.2%, and there were 4 cases of stent dysfunction, with 1 case of bare stent and 3 cases of dual stent.ConclusionTIPS is an effective procedure for the treatment of cirrhotic portal hypertension complications, since it can reduce portal pressure and significantly alleviate ascites. Liver function is impaired in short-term after TIPS, but TIPS has no significant effect on liver function in middle-term.