摘要
目的:探讨经颈静脉肝内门体分流术治疗慢性期肝小静脉闭塞症(HVOD)的可行性。方法:慢性期HVOD患者16例为2016年5月至2020年10月郑州大学第一附属医院介入科收治的病例,男11例,女5例,年龄18~80岁,均接受经颈静脉肝内门体分流术治疗。观察患者肝功能恢复情况、术后存活情况以及手术并发症发生情况。结果:所有患者手术均一次性成功,术中均未出现严重并发症,术后未再出现呕血。术后红细胞计数较术前未见明显减低,谷丙转氨酶[28.0(18.5,49.8)vs 66.0(32.5,87.5)μmol/L]、谷草转氨酶[48.0(33.0,58.0)vs 63.5(44.0,105.3)μmol/L]、总胆红素[(34.96±9.31)vs(63.14±28.15)μmol/L]、血氨[(59.26±16.56)vs(77.17±24.61)μmol/L]均较术前下降(P<0.05)。术后血清白蛋白与术前比差异无统计学意义,但凝血酶原时间延长[(21.93±6.49)vs(15.73±2.89) s,P<0.05]。术后1例患者出现顽固性肝性脑病,出院后1个月死亡,其余15例均长期存活。结论:经颈静脉肝内门体分流术可有效治疗慢性期HVOD导致的消化道出血,存活率高、并发症少。
Aim:To investigate the feasibility of transjugular intrahepatic portosystemic shunt(TIPS) in the treatment of chronic hepatic veno-occlusive disease(HVOD).Methods:A retrospective analysis of 16 chronic HVOD patients treated with TIPS in the Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University,from May 2016 to October 2020 was performed.There were 11 males and 5 females,and the patients aged from 18 to 80 years.Recovery of liver function,postoperative survival,and surgical complications were observed.Results:All the operations were successful at one time without serious complications or hematemesis again.After operation,the patients′red blood cell count was not significantly lower than that before operation;the level of alanine aminotransferase[28.0(18.5,49.8) vs 66.0(32.5,87.5) μmol/L],aspartate aminotransferase[48.0(33.0,58.0) vs 63.5(44.0,105.3) μmol/L],total bilirubin [(34.96±9.31) vs(63.14±28.15) μmol/L],and blood ammonia[(59.26±16.56) vs(77.17±24.61) μmol/L] were significantly decreased(P<0.05);serum albumin did not change significantly after operation,while prothrombin time was increased[(21.93±6.49) vs(15.73±2.89) s](P<0.05).One patient developed intractable hepatic encephalopathy,and died one month after discharge.The remaining 15 patients survived till study deadline.Conclusion:TIPS is effective in treatment of chronic HVOD,with high survival rate and fewer complications.
作者
李宗明
韩新巍
丁鹏绪
周朋利
焦德超
雷钦宇
徐苗
LI Zongming;HAN Xinwei;DING Pengxu;ZHOU Pengli;JIAO Dechao;LEI Qinyu;XU Miao(Department of Interventional Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2022年第3期422-426,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省医学科技攻关计划省部共建青年计划项目(SB201902005)。
关键词
经颈静脉肝内门体分流术
肝小静脉闭塞症
土三七
腹水
肝功能衰竭
肝性脑病
transjugular intrahepatic portosystemic shunt
hepatic veno-occlusive disease
Sedium aizoon
ascites
liver failure
hepatic encephalopathy
