胃冠状静脉栓塞术在门脉高压性上消化道出血经颈静脉肝内门腔静脉分流术患者中的临床疗效  

Clinical efficacy of gastri coronary vein embolization in patients with portal hypertensive upper gastrointestinal bleeding and transjugular intrahepatic portosystemic stent shunt

作　　者：秦鹏 李树森 刘皓 吴广迎 Qin Peng;Li Shusen;Liu Hao;Wu Guangying(Department of Interventional Vascular Surgery,the Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei,China)

机构地区：[1]邢台医专第二附属医院介入血管外科,河北邢台054000

出　　处：《血管与腔内血管外科杂志》2022年第9期1130-1134,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨胃冠状静脉栓塞术(GCVE)在门脉高压性上消化道出血经颈静脉肝内门腔静脉分流术(TIPS)患者中的临床疗效。方法收集2018年3月至2020年6月邢台医专第二附属医院收治的81例门脉高压性上消化道出血行TIPS患者的临床资料,根据治疗方法的不同将其分为TIPS组(n=40)和TIPS+GCVE组(n=41)。比较两组患者的手术指标、术后并发症、术后门静脉血流动力学指标、肝功能指标及术后1年内复发情况。结果TIPS+GCVE组患者手术时间明显长于TIPS组患者,差异有统计学意义(P<0.01);两组患者术后恢复时间比较,差异无统计学意义(P>0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P>0.05)。术后1周及术后1个月,两组患者门静脉直径、门静脉压力均低于本组术前,门静脉流速均高于本组术前,差异均有统计学意义(P<0.05);但两组患者上述指标比较,差异均无统计学意义(P>0.05)。术后3个月,两组患者丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平及血小板计数(PLT)均低于本组术前,白蛋白(ALB)水平均高于本组术前,差异均有统计学意义(P<0.05);但两组患者上述指标比较,差异均无统计学意义(P>0.05)。术后随访1年,两组患者复发率比较,差异无统计学意义(P>0.05)。结论TIPS联合GCVE治疗门脉高压性上消化道出血患者的临床效果显著,可调节门静脉血流状态,降低再出血率,具有较好的临床价值。Objective To investigate the clinical effect of gastric coronary venous embolization(GCVE)in patients with portal hypertensive upper gastrointestinal bleeding with the transjugular intrahepatic portocaval shunt(TIPS).Method The clinical data of 81 patients with portal hypertensive upper gastrointestinal bleeding who received TIPS from March 2018 to June 2020 in the Second Affiliated Hospital of Xingtai Medical College were collected.They were divided into TIPS group(n=40)and TIPS+GCVE group(n=41)according to different treatment methods.The surgical indicators,postoperative complications,postoperative portal vein hemodynamic indicators,liver function indicators,and recurrence within one year after the surgery were compared between the two groups.Result The operation time of the TIPS+GCVE group was significantly longer than that of the TIPS group,the difference was statistically significant(P<0.01).There was no significant difference in the length of postoperative recovery time between the two groups(P>0.05).There was no significant difference in the total incidence rate of postoperative complications between the two groups(P>0.05).After operation 1 week and 1 month,the portal vein diameter and portal vein pressure in the two groups were lower than their before operation,and the portal vein velocity was higher than their before operation,the differences were statistically significant(P<0.05),however,there were no significant differences in the foregoing indicators between the two groups(P>0.05).After operation 3 months,the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and platelet count(PLT)in the two groups were lower than their before operation,the levels of albumin(ALB)in the two groups were higher than their before operation,the differences were statistically significant(P<0.05),however,there were no significant differences in the foregoing indicators between the two groups(P>0.05).During one-year follow-up,there was no significant difference in recurrence between

关 键 词：胃冠状静脉栓塞术 经颈静脉肝内门腔静脉分流术 门脉高压 上消化道出血 门静脉血流动力学 肝功能 

分 类 号：R543[医药卫生—心血管疾病]