TIPS用于肝细胞癌伴症状性门静脉高压等候肝移植期间患者  

TIPS applicated in hepatocellular carcinoma complicated with symptomatic portal hypertension patients waiting liver transplantation

作　　者：王宏亮 张岳林[1] 王凯冰 周坦洋[1] 周官辉[1] 孙军辉[1] WANG Hongliang;ZHANG Yuelin;WANG Kaibing;ZHOU Tanyang;ZHOU Guanhui;SUN Junhui(Hepatobiliary and Pancreatic Intervention Center,Zhejiang Clinical Medical Research Center for Hepatobiliary and Pancreatic Diseases,Zhejiang Research Center for Diagnosis and Treatment Technology of Severe Hepatobiliary Diseases,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院肝胆胰介入中心,浙江省肝胆胰疾病临床医学研究中心,浙江省重症肝胆疾病(移植)诊治技术研究中心,浙江杭州310003

出　　处：《中国介入影像与治疗学》2023年第1期22-25,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的 观察TIPS用于肝细胞癌(HCC)伴症状性门静脉高压(SPH)等待肝移植(LT)患者的价值。方法 纳入7例因HCC伴SPH接受TIPS并等待LT患者,评价TIPS的应用价值。结果 7例TIPS均成功。TIPS后SPH症状和体征明显缓解,门静脉压力梯度明显降低(P<0.05)。5例消化道出血术后无再出血,2例腹腔积液术后积液量明显减少。1例术后支架狭窄,1例出现肝性脑病。等待LT期间7例均接受针对HCC的综合介入治疗,包括射频消融2例、TACE 5例;2例肿瘤完全缓解,3例部分缓解,疾病稳定和病情进展各1例。中位等待LT时间为10.6个月,LT术后均未出现肿瘤复发及死亡病例。结论 TIPS可作为HCC伴SPH患者等待LT期间的桥梁治疗。Objective To observe the value of TIPS applicated in hepatocellular carcinoma(HCC) complicated with symptomatic portal hypertension(SPH) patients waiting liver transplantation(LT). Methods Seven HCC complicated with SPH patients who finally underwent LT after TIPS were enrolled, and the value of TIPS was observed. Results TIPS was successfully performed in all 7 cases. The symptoms and signs of SPH resolved significantly, and the portal vein pressure gradient significantly reduced after TIPS(P<0.05). The hemostatic effect was obvious in 5 cases with esophageal variceal bleeding, and there was no rebleeding after TIPS. Meanwhile, significant reduction of ascites was found in 2 cases. Stent stenosis occurred in 1 case, and hepatic encephalopathy occurred in 1 patient. All 7 patients underwent comprehensive interventions when waiting for LT, including radiofrequency ablation in 2 cases and TACE in 5 cases, and complete response alleviated in 2 cases, partial response alleviated in 3 cases, while stable and progressed disease was found each in 1 case, respectively. The median waiting time for LT was 10.6 months, while no tumor recurrence nor death occurred after LT. Conclusion TIPS could be used as a bridge therapy for HCC complicated with SPH patients waiting for LT.

关 键 词：癌 肝细胞 肝移植 高血压 门静脉 门体分流术 经颈静脉肝内 

分 类 号：R735.7[医药卫生—肿瘤] R815[医药卫生—临床医学]