[1]李玉莲,李亚敏,李玉辉,等.经颈静脉肝内门体分流术后肝性脑病预防及管理的最佳证据总结[J].介入放射学杂志,2026,(06):672-678.[doi:10.3969/j.issn.1008-794X.2026.06.017 ]
　LI Yulian,LI Yamin,LI Yuhui,et al.Summary of the best evidence for the prevention and management of hepatic encephalopathy occurring after transjugular intrahepatic portosystemic shunt surgery[J].J Intervent Med,2026,(06):672-678.[doi:10.3969/j.issn.1008-794X.2026.06.017 ]
点击复制

经颈静脉肝内门体分流术后肝性脑病预防及管理的最佳证据总结()

PDF下载中关闭

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

卷:
期数:
2026年06
页码:
672-678
栏目:
护理论坛
出版日期:
2026-06-17

文章信息/Info

Title:
Summary of the best evidence for the prevention and management of hepatic encephalopathy occurring after transjugular intrahepatic portosystemic shunt surgery
文章编号:
1008-794X(2026)-006-0672-07
作者:
李玉莲;  李亚敏;  李玉辉;  唐 露;  刘欢欢
410005 湖南长沙 湖南省人民医院(湖南师范大学附属第一医院)介入血管外科
Author(s):
LI Yulian; LI Yamin; LI Yuhui; TANG Lu; LIU Huanhuan.
Department of Interventional Vascular Surgery,Hunan Provincial People's Hospital(First Affiliated Hospital of Hunan Normal University),Changsha,Hunan Province 410005,China
关键词:
经颈静脉肝内门体分流术;  肝性脑病;  预防;  管理;  证据总结
分类号:
R657.3
DOI:
10.3969/j.issn.1008-794X.2026.06.017
文献标志码:
A
摘要:
目的 汇总经颈静脉肝内门体分流术(TIPS)后肝性脑病预防及管理的最佳证据,为临床实践提供参考。方法 按照“6S”金字塔模型系统检索BMJ Best Practice、JBI、Up To Date、The Cochrane Library、CINAHL、Web of Science、Embase、PubMed、医脉通、国际指南协作网、美国国立指南网、苏格兰院际指南网、新西兰指南协作组、CNKI、万方、维普、CBM等数据库/网站,检索时限为建库至2025年1月31日。采用文献质量评价工具评价纳入文献质量,并提取证据。结果 共纳入文献15篇,从高风险因素识别、评估与筛查、预防措施、药物治疗、营养支持、中医支持、出院健康指导等7个方面共提取16条证据形成证据总结。结论 该研究汇总TIPS后肝性脑病预防与管理的最佳证据,为临床实践提供循证依据,有助于优化患者预后。

参考文献/References:

[1] Wang LJ,Yao X,Qi Q,et al.Prevention and treatment of hepatic encephalopathy during the perioperative period of transjugular intrahepatic portosystemic shunt[J].World J Gastrointest Surg,2023,15:1564-1573.
[2]Boike JR,Thornburg BG,Asrani SK,et al.Advancing Liver Therapeutic Approaches(ALTA)Consortium.North American Practice-Based Recommendations for Transjugular Intrahepatic Portosystemic Shunts in Portal Hypertension[J].Clin Gastroenterol Hepatol,2022,20:1636-1662.e36.
[3]Lv Y,Yang ZP,Liu L,et al.AVB-TIPS Study Group.Early TIPS with covered stents versus standard treatment for acute variceal bleeding in patients with advanced cirrhosis:a randomised controlled trial[J].Lancet Gastroenterol Hepatol,2019,4:587-598.
[4]王澜静,秦建平,姚 欣,等.乙型肝炎肝硬化门静脉高压患者经颈静脉肝内门体分流术后显性肝性脑病风险预测模型的构建[J].临床肝胆病杂志,2024,40:1149-1155.
Wang Lanjing,Qin Jianping,Yao Xin,et al.Construction of a risk prediction model for overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with hepatitis B cirrhosis and portal hypertension[J].Journal of Clinical Hepatobiliary Diseases,2024,40:1149-1155.
[5]陈 杨,刘家成,杨崇图,等.经颈静脉肝内门体分流术后肝性脑病预后因素研究进展[J].介入放射学杂志,2022,31:301-306.
Chen Yang,Liu Jiacheng,Yang Chongtu,et al.Research progress on prognostic factors of hepatic encephalopathy after tranjugular intrahepatic portosystemic shunt[J].J Interv Radiol,2022,31:301-306.
[6]中华医学会肝病学分会.肝硬化肝性脑病诊疗指南(2024年版)[J].中华肝脏病杂志,2024,32:799-812.
Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the Diagnosis and Treatment of Hepatic Encephalopathy in Liver Cirrhosis(2024 Edition)[J].Chinese Journal of Hepatology,2024,32:799-812.
[7]曾 欣,王 剑,林 勇,等.中国隐匿性肝性脑病临床诊治专家共识意见[J].胃肠病 学,2023,28:722-738.
Zeng X,Wang J,Lin Y,et al.Expert Consensus on the Clinical Diagnosis and Treatment of Occult hepatic encephalopathy in China[J].Gastroenterology,2023,28:722-738.
[8]何 新,张卓然,贺俊芝,等.肝性脑病临床指南和共识的质量评价及推荐意见研究[J].中西医结合肝病杂志,2024,34:140-146,152.
He X,Zhang ZR,He JZ,et al.Research on the Quality Evaluation and Recommendation of Clinical Guidelines and Consensus for Hepatic encephalopathy[J].Journal of Integrated Traditional Chinese and Western Medicine for Hepatology,2024,34:140-146,152.
[9]朱 政,胡 雁,邢唯杰,等.不同类型循证问题的构成[J].护士进修杂志,2017,32:1991-1994.
Zhu Z,Hu Y,Xing WJ,et al.The composition of different types of evidence-based questions[J].Journal of Nurses Training,2017,32:1991-1994.
[10]朱 政,胡 雁,周英凤,等.推动证据向临床转化(五)证据临床转化研究中的文献质量评价[J].护士进修杂志,2020,35:996-1000.
Zhu Z,Hu Y,Zhou YF,et al.Promoting the transformation of evidence into clinical practice(v)evaluation of literature quality in evidence clinical transformation research[J].Journal of Nursing Training,2020,35:996-1000.
[11]Foster MJ,Shurtz S.Making the critical appraisal for summaries of evidence(CASE)for evidence-based medicine(EBM):critical appraisal of summaries of evidence[J].J Med Libr Assoc,2013,101:192-198.
[12]The Joanna Briggs Institute(JBI).Checklist for systematic reviews[EB/OL].(2017-07-15)[2025-01-05].https://jbi.global/critical-appraisal-tools.
[13]周英凤,胡 雁,朱 政,等.JBI循证卫生保健中心文本证据的质量评价清单[J].护士进修杂志,2024,39:1075-1080.
Zhou YF,Hu Y,Zhu Z,et al.The quality evaluation checklist of textual evidence of the JBI evidence-based health care center[J].Journal of Continuing Nursing,2024,39:1075-1080.
[14]王春青,胡 雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30:964-967.
Wang CQ,Hu Y.JBI evidence pre-grading and evidence recommendation level system(2014 edition)[J].Journal of Nursing Training,2015,30:964-967.
[15]Lorenzo Ridola,Oliviero Riggio.Hepatic encephalopathy in adults:Clinical manifestations and diagnosis[DB/OL].(2024-09-27)[2025-01-18].http://www.uptodate.zdby.sjuku.top/contents/hepatic-encephalopathy-in-adults-clinical-manifestations-and-diagnosis.
[16]Lorenzo Ridola,Oliviero Riggio.Hepatic encephalopathy in adults:Treatment[DB/OL].(2024-09-19)[2025-01-18].http://www.uptodate.zdby.sjuku.top/contents/hepatic-encephalopathy-in-adults-treatment.
[17]Thabut D,Bouzbib C,Meunier L,et al.Association Française pour l'Etude du Foie(AFEF)group of experts of HE recommendations.Diagnosis and management of hepatic encephalopathy:the French recommendations[J].Liver Int,2023,43:750-762.
[18]European Association for the Study of the Liver.EASL Clinical Practice Guidelines on the management of hepatic encephalopathy[J].J Hepatol,2022,77:807-824.
[19]Korean Association for the Study of the Liver(KASL).KASL clinical practice guidelines for liver cirrhosis:varices,hepatic encephalopathy,and related complications[J].Clin Mol Hepatol,2020,26:83-127.
[20]American Association for the Study of Liver Diseases,European Association for the Study of the Liver.Hepatic encephalopathy in chronic liver disease:2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases[J].J Hepatol,2014,61:642-659.
[21]Rifaximin for preventing episodes of overt hepatic ncephalopathy[EB/OL].(2015-03-25)[2025-01-28].https://www.nice.org.uk/guidance/ta337.
[22]Magtoto,Leaderlou S."Hepatic Encephalopathy(Management):Probiotics"[DB/OL].(2021):JBI EBP Database.Web.16 February.2025. <http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=jbi&NEWS=N&AN=JBI10641>.
[22]Liang A,Brar S,Almaghrabi M,et al.Primary prevention of hepatic encephalopathy post-TIPS:a systematic review and meta-analysis[J].Medicine(Baltimore),2023,102:e35266.
[23]Ahmed Z,Hassan M,Arif SF,et al.Comparative efficacy of treatment options for the prevention of post-TIPS hepatic encephalopathy:a systematic review and network meta-analysis[J].J Gastrointestin Liver Dis,2023,32:70-76.
[24]肖 芳,肖书萍,陈冬萍,等.经颈静脉肝内门体静脉分流术后患者发生肝性脑病危险因素的Meta分析[J].临床消化病杂志,2023,35:395-402.
Xiao F,Xiao SP,Chen DP,et al.Meta-analysis of risk factors for hepatic encephalopathy in patients after tranjugular intrahepatic portosystemic shunt[J].Journal of Clinical Gastroenterology,2023,35:395-402.
[25]中华医学会放射学分会护理工作组,徐 寅,费晓燕,等.门静脉高压患者经颈静脉肝内门体分流术护理管理专家共识[J].介入放射学杂志,2022,31:117-124.
Nursing Working Group of Radiology Branch of Chinese Medical Association,Xu Yin,Fei Xiaoyan,et al.Expert Consensus on Nursing Management of Transjugular Intrahepatic Portosystemic shunt in Patients with Portal Hypertension[J].J Interv Radiol,2022,31:117-124.
[26]Bajaj JS,Lauridsen M,Tapper EB,et al.Important unresolved questions in the management of hepatic encephalopathy:an ISHEN consensus[J].Am J Gastroenterol,2020,115:989-1002.
[27]Shawcross DL,Dunk AA,Jalan R,et al.New Insights Steering Committee.How to diagnose and manage hepatic encephalopathy:a consensus statement on roles and responsibilities beyond the liver specialist[J].Eur J Gastroenterol Hepatol,2016,28:146-152.
[28]杨 凯,张学贤,赵 卫,等.经颈静脉肝内门体分流术后肝性脑病研究进展[J].介入放射学杂志,2021,30:1180-1183.
Yang K,Zhang XX,Zhao W,et al.Research progress of hepatic encephalopathy after intrahepatic portosystemic shunt via jugular vein[J].J Interv Radiol,2021,30:1180-1183.
(收稿日期:2025-05-28)
(本文编辑:茹 实)

相似文献/References:

[1]郭添胜,姜在波,黄明声,等.原发性肝癌合并糖尿病介入治疗的围手术期处理[J].介入放射学杂志,2000,(03):182.
[2]王茂强,王志强,王仲朴,等.经颈静脉途径肝内门-腔静脉分流术后肝性脑病的原因及其预防[J].介入放射学杂志,1998,(02):71.
[3]张书田,崔进国.经颈静脉肝内门体分流术对肝功能影响的初步研究[J].介入放射学杂志,1998,(04):220.
[4]谢苏庆,许国铭.治疗门脉高压的新途径——经颈静脉肝内门体分流术[J].介入放射学杂志,1994,(02):116.
[5]杨建勇,刘子江.经颈静脉肝内门体静脉支撑架分流术[J].介入放射学杂志,1994,(03):165.
[6]Artbur M.Freedman,杨建勇.经颈静脉肝内门体静脉分流术的并发症[J].介入放射学杂志,1994,(04):236.
[7]冯常炜,李振峰,崔广林,等.经颈静脉肝内门-腔分流术治疗肝硬变门脉高压症——附5例报告[J].介入放射学杂志,1995,(04):215.
[8]原姗姗,韩国宏,樊代明.ＴＩＰＳ治疗门静脉高压并发症预后评价的现状[J].介入放射学杂志,2011,(03):245.
　YUAN Shan-shan,HAN Guo-hong,FAN Dai-ming..TIPS treatment of the complications of portal hypertension: the current status of its prognostic evaluation [J].J Intervent Med,2011,(06):245.
[9]李晓晖,练贤惠,蔡银科,等.经颈静脉肝内门体静脉分流术后并发症的观察与护理[J].介入放射学杂志,2000,(02):116.
[10]何创业,祁兴顺,帖 君,等.经颈内静脉肝内门体分流术联合封堵器封堵治疗肝硬化门脉高压伴自发性脾、胃-肾分流[J].介入放射学杂志,2013,(10):801.
　HE Chuang? ye,QI Xing? shun,TIE Jun,et al. Transjugular intrahepatic portosystemic shunt combined with Amplatzer plugging device therapy for cirrhotic portal hypertension with spontaneous spleno?蛳 gastric?蛳 renal shunt[J].J Intervent Med,2013,(06):801.
[11]张子曙,黄祥龙,沈天真,等.经颈静脉肝内门体分流术[J].介入放射学杂志,1994,(04):239.
[12]王小泽,李 肖.从评分到人工智能——经颈静脉肝内门体分流术后肝性脑病预测的演变与挑战[J].介入放射学杂志,2025,34(05):449.[doi:10.3969/j.issn.1008-794X.2025.05.001]
　WANG Xiaoze,LI Xiao.Department of Gastroenterology,West China Hospital,et al.From scoring to artificial intelligence:the evolution and challenges in predicting hepatic encephalopathy after TIPS[J].J Intervent Med,2025,34(06):449.[doi:10.3969/j.issn.1008-794X.2025.05.001]

备注/Memo

备注/Memo:
通信作者: 李亚敏 E-mail:aminny@csu.edu.cn
更新日期/Last Update: 2026-05-25