不同介入方案治疗门静脉高压致急性上消化道大出血的临床疗效观察  

Clinical Observation on the Efficacy of Different Intervention Schemes in the Treatment of Acute Upper Gastrointestinal Bleeding Caused by Portal Hypertension

作　　者：张凌云[1] 杜婕琼[1] 区志乐 ZHANG Lingyun;DU Jieqiong;QU Zhie(Gaoming District People's Hospital of Foshan City,Foshan 528500,China)

机构地区：[1]佛山市高明区人民医院,广东佛山528500

出　　处：《中国医药指南》2023年第22期82-84,共3页Guide of China Medicine

基　　金：不同介入方案治疗门静脉高压致急性上消化道大出血的临床疗效观察,项目编号:2020001004829。

摘　　要：目的 研究分析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)两种介入方案治疗静脉高压致急性上消化道大出血的临床疗效。方法 选取我院在2021年1月至2022年12月收治的32例肝硬化门脉高压引起的上消化道大出血患者作为研究对象,按照随机抽签法分为治疗组(n=18,采取TIPS治疗)和对照组(n=14,采取PTVE治疗),对比两组的临床疗效。结果 治疗组术后6、12、24 h的止血率与对照组相比较无差异性(P> 0.05);治疗组术后1、3、6个月出血复发率与对照组相比较无差异性(P> 0.05),而术后12个月出血复发率明显低于对照组(P <0.05);在术前、术后3个月、术后6个月两组的Child-Pugh评分、白蛋白水平比较两组均无差异(P> 0.05),术后12个月治疗组的Child-Pugh评分高于对照组,白蛋白水平低于对照组(P <0.05);两组直接胆红素水平在任一时间点比较均无差异(P> 0.05)。结论 TIPS治疗门静脉高压致急性上消化道大出血的远期疗效明显优于PTVE。Objective To study and analyze the clinical efficacy of two interventional schemes,jugular vein portal shunt(TIPS)and percutaneous transhepatic gastrocoronary vein embolization(PTVE),in the treatment of acute upper gastrointestinal bleeding caused by venous hypertension.Methods A total of 32 patients with upper gastrointestinal bleeding caused by cirrhosis portal hypertension admitted to our hospital from January 2021 to December 2022 were selected as the study subjects.They were randomly divided into a treatment group(n=18,treated with TIPS)and a control group(n=14,treated with PTVE).Compare the clinical efficacy of the two groups.Results There was no significant difference between the treatment group and the control group at 6,12,and 24 hours after surgery(P>0.05).The comparison of bleeding recurrence rates at different times after surgery showed that there was no difference in the bleeding recurrence rate between the treatment group and the control group at 1,3,and 6 months after surgery(P>0.05),while the treatment group was lower than the control group at 12 months after surgery(P<0.05).There was no difference in Child-Pugh score and albumin level between the two groups before operation,3 months after operation and 6 months after operation(P>0.05).At 12 months after operation,the Child-Pugh score of the treatment group was higher than that of the control group,and the albumin level was lower than that of the control group(P<0.05).Conclusion TIPS is superior to PTVE in the long-term efficacy of acute upper gastrointestinal bleeding caused by portal hypertension.

关 键 词：肝硬化 门静脉高压 上消化道大出血 TIPS PTVE 

分 类 号：R573.2[医药卫生—消化系统]