TIPS治疗门脉高压出血的介入治疗研究  

Interventional Therapy of TIPS in the Treatment of Portal Hypertension

作　　者：郭俊 赵文军 吕洋 孙小荣[2] GUO Jun;ZHAO Wenjun;LYU Yang;SUN Xiaorong(Second Affiliated Hospital of Baotou Medical College;Baotou Medical College,Baotou 014030,China)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院,内蒙古包头014030 [2]内蒙古科技大学包头医学院

出　　处：《包头医学院学报》2018年第12期6-9,共4页Journal of Baotou Medical College

摘　　要：目的:分析应用介入微创TIPS在肝硬化门脉高压合并出血效果及应有价值。方法:回顾性分析40例肝硬化门脉高压致消化道大出血介入治疗,分析其并发症及近期疗效,同时评价介入治疗方法的有效性及安全性。结果:纳入肝硬化门脉高压所致的上消化道大出血患者40例,手术顺利,术后无重大并发症。术后跟踪随访,发现2例发生肝性脑病,其中1例因饮食不当,食高脂高蛋白饮食而发生肝性脑病,经内科保守治疗后恢复。2例发生分流道再狭窄,经球囊扩张后再次通畅,1例再出血,再次行胃冠状静脉栓塞术。结论:TIPS在肝硬化门脉高压致上消化道出血方面,起到立竿见影,快速止血的作用,具有微创、有效、安全独特优势,在临床上有较好应用价值,应大力推广。Objective:To analyze the effect of interventional minimally invasive TIPS in hepatic cirrhosis with portal hypertension combined with hemorrhage.Methods:A retrospective analysis of40cases of cirrhotic portal hypertension caused by gastrointestinal bleeding,analysis of its complications and short-term efficacy,and evaluation of the effectiveness and safety of interventional therapy.Results:Forty patients with upper gastrointestinal hemorrhage caused by cirrhotic portal hypertension were successfully operated and there were no major complications after operation.Follow-up after follow-up,it was found that there were2cases of hepatic encephalopathy,and one of them was due to improper diet and eating high-fat high-protein diet and then leading to hepatic encephalopathy,and finally to medical recovery after conservative treatment.Two cases of shunt restenosis occurred,and the stenosis was re-opened after balloon dilatation.One case was rebleeded and the coronary artery venous embolization was performed again.Conclusion:TIPS plays an immediate role in the treatment of upper gastrointestinal hemorrhage caused by cirrhotic portal hypertension.It has the advantages of minimally invasive,effective and safe.It has good application value in clinical practice and should be promoted.

关 键 词：肝硬化失代偿期 食管胃底静脉曲张 经颈静脉肝内门体静脉分流术(TIPS) 肝性脑病(HE) 

分 类 号：R575.2[医药卫生—消化系统]