昆明医学院学报2011，Vol.32Issue(6)：62-67,6.
Tips治疗肝硬化门静脉高压症126例随访研究
The Treatment of Liver Cirrhosis Complicated with Portal Hypertension by Transjugalar Intrahepatic Portosystemic Shunt (a Follow-up Study of 126 Cases)
摘要
Abstract
Objective To discuss the curative effects, the incidence of complications, the reason and the management of transjugalar intrahepatic portosystemic shunt (Tips) in treatment of the patients with liver cirrhosis complicated with portal hypertension. Methods The data of 126 patients who received Tips treatment in recent 4 years in our hospital were summarized. All patients were performed Tipss and gastic vein occlusion. The portal venous pressure, portosystemic pressure gradients, haemogram, blood coagulation, hepatic and renal function,blood ammonia, imaging and endoscopy results were monitored before and after Tips treatment. All patients were followed up for 2 weeks to 4 years, and the incidence of complications such as alimentary tract hemorrhage, stent reocclusion, hepatic encephalopathy, hepatic failure were observed. Results The 98.4％ (124/126) patients were succesful performed Tips treatment. The portal venous pressure decreasd from (27.41 ± 5.36) mmhg pre-operation to (20.04 ±4.32) mmHg post-operation, and there was a statistic difference between pre-operation and post-operation (P ＜ 0.001 ). 23 patients with acute gastic hernorrhoge were Performed the emengent Tips treatment and the bleeding was successfully stopped (the instant hemostasis rate was 100％ ). The remission rate of reforactory ascites in 126 patients was 72％ (91/126). There were 28 patients with hepatic encephalopathy, 22 patients with re-heamomhage of gastic tract, 20 patients with narrow or ocullusion in stent,6 patients with liver function failure and 16 cases of death. Conclusions The combination of Tips and gastic vein occlusion is a usefull and safe treatment for patients with esophagus and gastric hemorrhage. Selecting the suitable patients, settlement of the stents, anti-coagutation drugs may improve the curative effects, decrease the comptication, and save time for liver tansptantation.关键词
颈静脉肝内门体分流术/肝硬化/门静脉高压Key words
Transjugalar intrahepatic portosystemic shunt/ Liver cirrhosis/ Portal hypertension分类
医药卫生引用本文复制引用
胥莹,郭涛,刘桂兰,闫东,杨晋辉,李迎春..Tips治疗肝硬化门静脉高压症126例随访研究[J].昆明医学院学报,2011,32(6):62-67,6.基金项目
云南省应用基础研究基金资助项目(2010CD171) （2010CD171）
