[1]陈斯良,胡 朋,林志鹏,等.经颈静脉肝内门体静脉分流术治疗肝硬化门静脉高压症脾切除断流术后症状复发临床效果 [J].介入放射学杂志,2018,27(04):374-379.
 CHEN Siliang,HU Peng,LIN Zhipeng,et al.TIPS for the treatment of recurrent symptoms in patients with cirrhotic portal hypertension after splenectomy devascularization: analysis of clinical efficacy[J].journal interventional radiology,2018,27(04):374-379.
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经颈静脉肝内门体静脉分流术治疗肝硬化门静脉高压症脾切除断流术后症状复发临床效果 



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

卷:
27
期数:
2018年04期
页码:
374-379
栏目:
临床研究
出版日期:
2018-04-25

文章信息/Info

Title:
TIPS for the treatment of recurrent symptoms in patients with cirrhotic portal hypertension after splenectomy devascularization: analysis of clinical efficacy
作者:
陈斯良 胡 朋 林志鹏 赵剑波
Author(s):
CHEN Siliang HU Peng LIN Zhipeng ZHAO Jianbo
Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province 510515, China
关键词:
【关键词】 肝硬化 门静脉高压症 经颈静脉肝内门体静脉分流术 脾切除断流术 临床疗效
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(TIPS)治疗肝硬化门静脉高压症脾脏断流术后症状复发的临床效果。方法 回顾性分析2010年1月至2015年12月因肝硬化门静脉高压症接受TIPS术治疗的192例患者临床资料。其中既往接受过脾切除断流术48例(A组),未接受脾切除断流术144例(B组)。采用Cox回归模型分析影响术后疗效及预后的因素。对比分析两组术后门静脉高压症状缓解情况及临床疗效。结果 TIPS术后192例患者均成功建立肝内门体分流道,随访5~65个月,平均(35.13±7.68)个月。TIPS术前、术后A组血小板计数均高于B组(P<0.01),A组术后远期肝功能优于B组(P<0.05),A组术后肝性脑病(HE)发生率低于B组(P<0.05),两组术后分流道通畅率及生存率差异均无统计学意义(P>0.05)。肝硬化门静脉高压症脾脏断流术后症状复发患者随访9~64个月,TIPS术后门静脉高压症状可在短期内有效缓解。Cox回归模型分析显示术前Child- Pugh评分(HR=1.653,95%CI=1.721~3.298,P=0.003)、HE(HR=1.023,95%CI=0.908~0.965,P=0.008)及脾切除(HR=0.981,95%CI=1.019~1.584,P=0.041)是影响术后HE的独立影响因素。结论 TIPS术治疗肝硬化门静脉高压症脾切除断流术后症状复发患者效果良好。术前接受脾切除断流术对术后支架分流道通率及生存率无明显影响,术后HE发生率较低,可能获得较好的远期肝功能。

参考文献/References:

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备注/Memo

备注/Memo:
(收稿日期:2017-06-04)
(本文编辑:边 佶)
更新日期/Last Update: 2018-04-16