[1]方主亭 唐 仪 吴少杰 周艳峰 杨厚林 陈良生 蔡森林 何剑锋.经颈静脉肝内门体分流术治疗肝硬化顽固性腹水8例[J].福建医药杂志,2019,41(02):13-16.
 FANG Zhuting,TANG Yi,WU Shaojie,et al.Application of transjugular intrahepatic portosystemic shunt in cirrhotic patients with refractory ascites[J].FUJIAN MEDICAL JOURNAL,2019,41(02):13-16.
点击复制

经颈静脉肝内门体分流术治疗肝硬化顽固性腹水8例()
分享到:

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
41
期数:
2019年02期
页码:
13-16
栏目:
临床研究
出版日期:
2019-01-30

文章信息/Info

Title:
Application of transjugular intrahepatic portosystemic shunt in cirrhotic patients with refractory ascites
文章编号:
1002-2600(2019)02-0013-04
作者:
方主亭 唐 仪 吴少杰 周艳峰 杨厚林 陈良生 蔡森林 何剑锋
福建医科大学省立临床医学院 福建省立医院介入放射科(福州 350001)
Author(s):
FANG Zhuting TANG Yi WU Shaojie ZHOU Yanfeng YANG Houlin CHEN Liangsheng CAI Senlin HE Jianfeng.
Department of Interventional Therapy, Fujian Provincial Hospital,Provincial Clinical Medical College of Fujian Medical University,Fuzhou 350001, China
关键词:
经颈静脉肝内门体分流术 肝硬化 顽固性腹水
Keywords:
transjugular intrahepatic portosystemic shunt liver cirrhosis refractory ascites
分类号:
R657.31
文献标志码:
B
摘要:
目的 观察采用经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt,TIPS)治疗肝硬化顽固性腹水患者的疗效。方法 对8例肝硬化顽固性腹 水患者采用TIPS 治疗,观察其临床疗效,并对肝功能、血氨、凝血酶原时间及并发症等指标进 行随访观察。结果 对于肝硬化顽固性腹水的患者行TIPS治疗后门静脉压力显著下降,患者腹围 显著小于治疗前,尿量显著增加。显效3例,有效4例。1例患者因穿刺后肝包膜出血,予行肝动脉 栓塞后导致慢性肝功能衰竭而死亡。结论 TIPS治疗肝硬化顽固性腹水疗效确切。
Abstract:
Objective To observe the effects of the treatment of refractory ascites in cirrhotic patients using transjugular intrahepatic portosystemic shunt (TIPS). Methods The clinical effects of eight cirrhotic patients with refractory ascites who were treated by TIPS were observed. Then we conducted the follow-up and measured the liver function, renal function, blood routine, blood ammonia and complications of the patients. Results The portal venous pressure declined significantly after TIPS. The abdominal girth reduced significantly than before. The urine volume increased significantly than before. Three cases were markedly effective. Four cases were effective.One patient died because of chronic liver failure. Conclusion The effects of the treatment of refractory ascites in cirrhotic patients using TIPS are exact.

参考文献/References:

[1] Planas R,Montoliu S, Balleste B, et al. Natural history of patients hospitalized for management of cirrhotic ascites[J]. Clin Gastroenterol Hepatol,2006,4(11):1385-1394.
[2] Krag A,Bendtsen F,Henriksen J H,et al. Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites[J]. Gut,2010,59(1):105-110.
[3] 中华医学会肝病学分会. 肝硬化腹水及相关并发症的诊疗指南[J]. 临床肝胆病杂 志,2017,33(10):1847-1863.
[4] de Franchis R. Expanding consensus in portal hypertension:Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol,2015,63(3):743-752.
[5] Bureau C,Thabut D,Oberti F,et al. Transjugular Intrahepatic Portosystemic Shunts With Covered Stents Increase Transplant-Free Survival of Patients With Cirrhosis and Recurrent Ascites[J]. Gastroenterology,2017,152(1):157-163.
[6] Bucsics T,Hoffman S,Grunberger J,et al. ePTFE-TIPS vs repetitive LVP plus albumin for the treatment of refractory ascites in patients with cirrhosis[J]. Liver Int,2018,38(6):1036-1044.
[7] Geeroms B,Laleman W,Laenen A,et al. Expanded polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunts in cirrhotic patients:Long-term patency and clinical outcome results[J]. Eur Radiol,2017,27 (5):1795-1803.
[8] Ferral H,Gamboa P,Postoak D W,et al. Survival after elective transjugular intrahepatic portosystemic shunt creation: prediction with model for end-stage liver disease score[J]. Radiology,2004,231(1):231-236.
[9] Maleux G,Perez-Gutierrez N A,Evrard S,et al. Covered stents are better than uncovered stents for transjugular intrahepatic portosystemic shunts in cirrhotic patients with refractory ascites:a retrospective cohort study[J]. Acta Gastroenterol Belg,2010,73(3):336-341.
[10] Miraglia R,Maruzzelli L,Tuzzolino F,et al. Transjugular Intrahepatic Portosystemic Shunts in Patients with Cirrhosis with Refractory Ascites: Comparison of Clinical Outcomes by Using 8- and 10-mm PTFE-covered Stents[J]. Radiology,2017,284(1):281-288.
[11] Wang Q,Lv Y,Chen H,et al. Use of 8-mm Covered TIPS:Is "Losses without Gains" the End of the Story?[J]. Radiology,2017,284(2):604.
[12] Gines P,Uriz J,Calahorra B,et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis[J]. Gastroenterology,2002,123(6):1839-1847.

更新日期/Last Update: 2019-01-30