经颈静脉肝内门体静脉分流术对脾功能亢进的影响研究  

Effect of transjugular intrahepatic portosystemic shunt on hypersplenism

作　　者：马元锦 赵卫[1] 潘文秋 陆孜 谭斌 卓松波 游占亮 胡继红[1] MA Yuanjin;ZHAO Wei;PAN Wenqiu;LU Zi;TAN Bin;ZHUO Songbo;YOU Zhanliang;HU Jihong(Department of Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,China)

机构地区：[1]昆明医科大学第一附属医院影像科,云南昆明650032

出　　处：《实用放射学杂志》2023年第1期128-131,共4页Journal of Practical Radiology

摘　　要：目的 探讨经颈静脉肝内门体静脉分流术(TIPS)对脾功能亢进的影响.方法 回顾性分析190例肝硬化门静脉高压(PH)患者的临床资料,比较术前与术后3 d、7 d、l个月、3个月、6个月、1年的肝功能、肾功能、外周血细胞、脾脏体积以及术后不良反应情况.结果 190例患者手术均获成功.白细胞(WBC)术后1个月内较术前相比差异有统计学意义(P<0.05);红细胞(RBC)于术后1个月开始升高,并于术后1年达到最高值,与术前相比差异有统计学意义(P<0.05);血小板(PLT)于术后1~6个月开始升高并达到最高,差异有统计学意义(P<0.05).患者肝功能1周内受损(P<0.05),随后较前恢复,术后1~12个月脾脏体积较术前均明显减小,差异有统计学意义(P<0.05).术后无严重不良反应以及死亡病例出现.结论 TIPS对于脾功能亢进具有较为明显的缓解作用,能够改善肝硬化PH患者外周血细胞数量、改善肾功能以及减少脾脏淤血并缩小脾脏体积.Objective To investigate the effect of transjugular intrahepatic portosystemic shunt(TIPS)on hypersplenism.MethodsT he clinical data of 190 patients with portal hypertension(PH)with cirrhosis admitted were analyzed retrospectively.The liver and kidney functions,peripheral blood cells,spleen volume and postoperative adverse reactions were compared before operation and 3 day,7 day,1 month,3 month,6 month and 1 year after operation.Results Operation was successful in all 190 patients.The difference in white blood cell(WBC)within 1 month postoperative compared to preoperative result was statistically significant(P<o.05).The red blood cell(RBC)began to rise at the first month after operation,and then reached the highest value at 1 year after operation,with a statistical significance(P<0.05).Platelet(PLT)was increased from 1 to 6 months after operation and reached the highest value,and the difference was statistically significant(P<0.05).The liver function of the patients was impaired within 1 week(P<0.05),and then recovered.The spleen volume from 1 to 12 months after operation was significantly lower than that before operation,with a statistical significance(P<0.05).No serious adverse reactions or deaths occurred after operation.Conclusion TIPS has obvious relieving effect on hypersplenism,and can improve peripheral blood cell number and renal function,and reduce spleen congestion to decrease its volume in patients with PHof cirrhosis.

关 键 词：肝硬化 门静脉高压 脾功能亢进 经颈静脉肝内门体静脉分流术 

分 类 号：R575.2[医药卫生—消化系统] R551.1[医药卫生—内科学] R815[医药卫生—临床医学]