[1]温 晨,袁 凯,马鹍鹏,等.经颈静脉肝内门体分流术治疗门静脉高压伴门静脉血栓的疗效与安全性[J].介入放射学杂志,2024,33(05):537-542.
　WEN Chen,YUAN Kai,MA Kunpeng,et al.Transjugular intrahepatic portosystemic shunt for portal hypertension with portal vein thrombosis： analysis of its efficacy and safety[J].journal interventional radiology,2024,33(05):537-542.
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经颈静脉肝内门体分流术治疗门静脉高压伴门静脉血栓的疗效与安全性()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年05
页码:
537-542
栏目:
临床研究
出版日期:
2024-06-03

文章信息/Info

Title:
Transjugular intrahepatic portosystemic shunt for portal hypertension with portal vein thrombosis： analysis of its efficacy and safety
作者:
温 晨;  袁 凯;  马鹍鹏;  向 涛;  王茂强;  段 峰
Author(s):
WEN Chen;  YUAN Kai;  MA Kunpeng;  XIANG Tao;  WANG Maoqiang;  DUAN Feng.
Department of Interventional Radiology， Chinese PLA General Hospital， Beijing 100853， China
关键词:
【关键词】 经颈静脉肝内门体分流术;  门静脉血栓;  门静脉海绵样变性;  肝性脑病
文献标志码:
A
摘要:
【摘要】 目的 探讨经颈静脉肝内门体静脉分流术（transjugular intrahepatic portosystemic shunt，TIPS）治疗门静脉高压伴门静脉血栓（portal vein thrombosis，PVT）的疗效及安全性。方法 纳入2017年12月至2022年10月中国人民解放军总医院收治的符合TIPS治疗指征的31例门静脉高压伴PVT患者。收集患者临床资料，包括术前实验室检查、术式选择、术中门静脉压力（portal vein pressure， PVP）、术后随访超声或增强CT检查及有无肝性脑病（hepatic encephalopathy，HE）等。采用配对t检验比较支架植入前后PVP差异，Kaplan-Meier曲线分析患者术后分流道通畅率、再出血率、HE发生率及生存率。Log-rank检验分析伴或不伴有门静脉海绵样变性（cavernous transformation of portal vein，CTPV）患者的随访结果差异。结果 TIPS成功率为93.55%（29/31）。手术成功的29例患者支架植入前后PVP由（30.15±4.61） mmHg降至（20.84±5.57） mmHg，差异有统计学意义（t=8.975，P＜0.05）。术后随访时间为22.90（4.50，61.80）个月。随访期间，24.14%（7/29）的患者出现分流道功能障碍，17.24%（5/29）的患者出现再出血，17.24%（5/29）的患者出现HE，17.24%（5/29）的患者死亡。10例PVT患者伴有CTPV，伴有CTPV患者的分流道功能障碍5例、再出血3例、HE 1例、死亡3例，不伴有CTPV患者的分流道功能障碍2例、再出血2例、HE 4例、死亡2例。伴有CTPV的PVT患者的分流道功能障碍及再出血发生率高于不伴CTPV的患者（均P＜0.05），而两组间HE发生率及术后病死率差异无统计学意义（均P＞0.05）。结论 TIPS可有效降低伴有PVT患者的PVP，PVT伴CTPV的患者TIPS后分流道功能障碍及再出血发生率高于不伴CTPV的患者。

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备注/Memo

备注/Memo:
（收稿日期：2023-06-07）
（本文编辑：新 宇）
更新日期/Last Update: 2024-06-03