原发性肝癌并门脉高压症TIPSS治疗的临床疗效研究  

The curative effect of transjugular intrahepatic portosystemic shunt in the treatment of liver cancer accompanied by portal hypertension

作　　者：任永强[1] 闻炜[1] 刘松涛[1] 李京雨[1] 

机构地区：[1]北京军区总医院肝病科,北京100700

出　　处：《胃肠病学和肝病学杂志》2010年第8期725-727,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的评价经颈静脉门体分流术（TIPSS）治疗在伴有门静脉高压的肝癌患者中的应用价值。方法回顾分析32例门静脉高压的肝癌患者行TIPSS治疗后门静脉压力变化及对部分化验指标的影响、术后并发症和术后生存期。结果术前术后门静脉压力从（27.23±9.45）mm Hg降至（16.67±5.34）mm Hg,压力大小变化有明显差异。临床血液化验指标比较无明显差异（P〉0.05）,而SCr、CHE、PT和APTT有明显差异（P〈0.05）。术后相关并发症主要有呼吸道感染、皮下血肿、肝性脑病和支架狭窄。生存时间为18~725天,中位生存时间为230天。30、90、180、360和720天的累计生存率分别为82%、64%、53%、40%和13%。结论TIPSS治疗可以有效降低门静脉压力、延长生存期、提高患者生存质量。Objective To evaluate the value of transjugular intrahepatic portosystemic shunt（TIPSS） in the treatment of portal hypertension associated with liver cancer patients. Methods A retrospective analysis was performed in thirtytwo liver cancer patients who were treated by TIPSS.The change of portal venous pressure after the treatment and the laboratory examination data were reviewed.The post-operative complications and postoperative survival time was analyzed by follow-up of patients. Results The portal venous pressure was significantly lowered from（27.23±9.45） mm Hg to（16.67±5.34） mm Hg after TIPSS.There was no significant difference when compare the clinical laboratory data of blood tests before and after surgery.However,the SCr,CHE,PT and APTT had a significant difference（P0.05）.Postoperative complications were mainly related to respiratory tract infection,subcutaneous hematoma,hepatic encephalopathy and stent restenosis.The survival time was from 18 to 725 days with a median survival time 230 days.The 30,90,180,360 and 720-day cumulative survival rates were 82%,64%,53%,40% and 13%,respectively. Conclusion The treatment of TIPSS can effectively reduce the portal pressure and prolong survival time in liver cancer patients accompanied by portal hypertension.The quality of patients＇ life can be improved.

关 键 词：经颈静脉肝内门体分流术 肝癌 门静脉高压 预后 

分 类 号：R735.7[医药卫生—肿瘤]