经颈静脉肝内门体静脉分流术后发生门静脉血栓的影响因素分析  

Analysis of the risk factor for portal vein thrombosis after transjugular intrahepatic portosystemic shunt

作　　者：李睿[1] 胡冬梅[1] 罗大勇[2] Li Rui;Hu Dongmei;Luo Dayong(Department of Ultrasound,the Second People's Hospital of Fuyang City,Fuyang 236029,Anhui,China;Department of General Surgery,the Second People's Hospital of Fuyang City,Fuyang 236029,Anhui,China)

机构地区：[1]阜阳市第二人民医院超声科,安徽阜阳236029 [2]阜阳市第二人民医院普外二科,安徽阜阳236029

出　　处：《血管与腔内血管外科杂志》2022年第7期886-890,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨经颈静脉肝内门体静脉分流术(TIPS)后发生门静脉血栓(PVT)的影响因素。方法收集2018年1月至2022年4月阜阳市第二人民医院行TIPS的51例患者的临床资料。根据是否发生PVT分为血栓组(n=14,发生PVT)和对照组(n=37,未发生PVT)。观察患者TIPS术前人口学指标、入院时的常规检测指标(血常规、肝功能、肾功能、凝血功能)、肝功能Child-Pugh分级,收集患者TIPS术后6个月随访结果,分析TIPS术后发生PVT的影响因素。结果两组患者D-二聚体(D-D)水平、纤维蛋白原(FIB)水平、肝功能Child-Pugh分级、消化道出血史比较,差异均有统计学意义(P<0.05)。两组患者门静脉主干直径(PVD)、门静脉血流速度(V)、门静脉血流量(Q)比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,V、肝功能Child-Pugh分级以及消化道出血史均是TIPS术后6个月发生PVT的影响因素(P<0.05)。结论术前V、消化道出血史、肝功能Child-Pugh分级与TIPS术后6个月PVT的发生有关,TIPS术前门静脉系统超声检查有利于评估术后PVT的发生风险。Objective To investigate the risk factor for portal vein thrombosis(PVT)after transjugular intrahepatic portosystemic shunt(TIPS).Method The clinical data of 51 TIPS patients in the Second People's Hospital of Fuyang City from January 2018 to April 2022 were collected.They were divided into thrombosis group(n=14,PVT)and control group(n=37,without PVT)according to their experience of PVT.Demographic indicators before TIPS,routine tests on admission(blood routine,liver function,renal function,coagulation function),Child-Pugh classification of liver function were observed,and 6 months follow-up results after TIPS were collected.The risk factors for PVT after TIPS were also analyzed.Result There were significant differences in D-dimer(D-D)level,fibrinogen(FIB)level,Child-Pugh grading of liver function,and gastrointestinal bleeding history between the two groups(P<0.05).There were significant differences in portal vein diameter(PVD),portal vein blood flow velocity(V),and portal vein blood flow(Q)between the two groups(P<0.05).Multivariate analysis showed that V,Child-Pugh grade of liver function,and gastrointestinal bleeding history were the risk factors for PVT 6 months after TIPS(P<0.05).Conclusion Preoperative V,gastrointestinal bleeding history,and Child-Pugh grade of liver function are associated with the occurrence of PVT 6 months after TIPS.Preoperative ultrasonography of the portal venous system with TIPS is helpful to assess the risk of postoperative PVT.

关 键 词：经颈静脉肝内门体静脉分流术 门静脉血栓 超声 

分 类 号：R543[医药卫生—心血管疾病]