TIPS和PTVE介入方法治疗肝硬化门静脉高压引起的上消化道出血的优劣差异  

TIPS and PTVE Intervention Methods for the Treatment of Upper Gastrointestinal Hemorrhage Caused by Portal Hypertension in Cirrhosis

作　　者：杨荣焕[1] YANG Rong-huan(Huizhou Central People’s Hospital,Huizhou,Guangdong,516001,China)

机构地区：[1]惠州市中心人民医院整创介入

出　　处：《黑龙江医学》2019年第9期1012-1013,1016,共3页Heilongjiang Medical Journal

基　　金：惠州市科技计划项目(2018Y024)

摘　　要：目的观察经颈静脉门静脉分流术(TIPS)和经皮肝穿刺胃冠状静脉栓塞术(PTVE)两种介入方法治疗肝硬化门静脉高压引起的上消化道出血的优劣差异。方法选取2015年3月—2017年8月间惠州市中心人民医院收治的肝硬化门静脉高压引起的上消化道出血患者60例进行研究,按照单双号法分为对照组(n=30,行PTVE)和治疗组(n=30,行TIPS),比较两组直接止血效果、术后复发率和肝功能改善情况。结果术后6h、术后12h止血率与对照组比较,差异无统计学意义(P>0.05);两组术后1月、3月、6月的出血复发率比较,差异无统计学意义(P>0.05);术后12月出血复发率比较,治疗组低于对照组(P<0.05);术后6个月两组肝功能恢复至正常、缓解率比较,组间差异有统计学意义(P<0.05)。结论TIPS和PTVE两种介入方法治疗肝硬化门静脉高压引起的上消化道出血近期疗效相当,但TIPS远期疗效更好,值得临床优先选择和推广。Objective To observe the difference between TIPS(transjugular portal vein shunt)and PTVE(percutaneous hepatic puncture and gastric coronary vein embolization)in the treatment of upper gastrointestinal bleeding caused by portal hypertension in cirrhosis. Methods Selecting 60 patients with upper gastrointestinal bleeding caused by liver cirrhosis portal hypertension in the hospi tal from March,2015 to August,2017. They were divided into control group(n=30,using PTVE)and treatment group(n=30,using TIPS)according to the single and double number method. Direct hemostatic effect,postoperative recurrence rate and liver function of two groups were compared. Results The hemostasis rate in 6h after treatment and 12h after treatment showed no significant difference with the control group(P>0.05). There was no significant difference between the two groups in the recurrence rate of bleeding recur rence rate 1 month,3 months and 6 months after surgery(P>0.05). The recurrence rate of postoperative hemorrhage 12 months after surgery was lower in the treatment group than in the control group(P<0.05). Liver function returned to normal and remission rate was compared between the two groups 6 months after surgery,and there was no significant difference between the control group and the treatment group(P<0.05). Conclusion The short-term efficacy of TIPS and PTVE in the treatment of upper gastrointestinal bleeding caused by portal hypertension in cirrhosis is comparable,but the long-term efficacy of TIPS is more obvious,which is worthy of clini cal priority and promotion.

关 键 词：肝硬化 门静脉高压 上消化道出血 PTVE TIPS 

分 类 号：R575.2[医药卫生—消化系统]