TIPS对肝硬化患者血流动力学及凝血功能的影响  

Effects of TIPS on Portal Hemodynamics and Coagulation Function in Patients with Cirrhosis Portal Hypertension

作　　者：李未华[1] 和海玉[1] 李英[1] 赵珍[2] 

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101 [2]昆明医科大学,云南昆明650500

出　　处：《昆明医科大学学报》2014年第8期83-85,共3页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金重点项目(2012Z077)

摘　　要：目的观察TIPS对肝硬化门脉高压症患者血流动力学及凝血功能的影响.方法对行TIPS的30例肝硬化门脉高压症患者,于术前2 d及术后7 d,均常规行血细胞分析、凝血功能检查及彩色多普勒超声测量门静脉主干压、内径和血流速度.结果 30例患者术后的门静脉压(23.66±5.53)mmHg与术前的(32.71±6.02)mmHg比较;门脉内径(1.15±0.23)cm与术前的(1.38±0.25)cm比较;门脉血流速度(19.26±2.21)cm/s与术前的(17.96±7.25)cm/s比较(P<0.05).术后的血小板计数(77.0±27.13)×109/L、凝血酶原时间(20.40±3.59)s、活化部分凝血活酶时间(41.48±7.78)s、凝血酶时间(12.05±1.73)s、纤维蛋白原(2.38±0.66)g/L分别与术前的血小板计数(64.7±29.41)×109/L、凝血酶原时间(18.53±2.66)s、活化部分凝血活酶时间(36.21±5.98)s、凝血酶时间(13.13±2.58)s、纤维蛋白原(2.10±0.70)g/L,均(P<0.05).结论TIPS能有效降低门静脉压压力,改善患者门脉系统及全身的血液循环,但术后有一定的再出血风险及支架栓塞或狭窄可能.Objective To observe the effects of TIPS on portal hemodynamics and coagulation function in patients with cirrhosis portal hypertension.Methods 30 patients with cirrhosis and portal hypertension who received TIPS,were given routine blood cell analysis,coagulation tests and Color Doppler ultrasound measurements of portal vein pressure,diameter and blood flow velocity two days before surgery and seven days after surgery.Results There were significant differences in portal pressure （32.71 ± 6.02 vs.23.66 ± 5.53 mmHg）,portal vein diameter （1.38 ± 0.25 vs.1.15 ± 0.23 cm）,and portal blood flow rate （17.96 ± 7.25 vs.19.26 ± 2.21） cm/s of 30 patients between before and after surgery （P＜0.05）.There were also significant differences in platelet count （64.7 ± 29.41 vs.77.0 ± 27.13） 109/L,prothrombin time （18.53 ± 2.66 vs.20.40 ± 3.59 seconds）,activated partial thromboplastin time （36.21 ± 5.98 vs.41.48 ± 7.78 seconds）,thrombin time （13.13 ± 2.58 vs.12.05 ± 1.73 seconds）,and fibrinogen （2.10 ± 0.70 vs.2.38 ± 0.66 g / L） between before and after surgery （P＜0.05） Conclusion TIPS can effectively reduce the portal venous pressure pressure,improve patient portal and systemic blood circulation,but there are certain risks of rebleeding and stent thrombosis or stenosis after operation.

关 键 词：经颈静脉肝内门体分流术 肝硬化 门脉高压 血流动力学 凝血功能 

分 类 号：R575.2[医药卫生—消化系统]