改良部分性脾动脉栓塞术治疗经颈静脉肝内门体分流术后肝性脑病的临床研究  

Clinical study of modified partial splenic artery embolization in the treatment of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt

作　　者：高峰[1] 黄祥忠[1] GAO Feng;HUANG Xiangzhong(Department of Intervention,Jiangyin Hospital Affiliated to Medical College of Southeast University,Jiangyin,Jiangsu,214400)

机构地区：[1]东南大学医学院附属江阴医院介入科,江苏江阴214400

出　　处：《实用临床医药杂志》2023年第14期95-98,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省医学会介入医学科研专项资基金资助项目(SYH-3201140-0034)。

摘　　要：目的观察改良部分性脾动脉栓塞术(MPSE)治疗经颈静脉肝内门体分流(TIPS)术后肝性脑病的效果。方法回顾性分析采用MPSE治疗的TIPS术后肝性脑病患者10例患者的资料。比较术前与术后3、6个月患者肝功能指标、门静脉主干血流速度、分流道血流速度。结果所有患者均成功完成MPSE,术后1例出现腹痛症状,其他患者均无明显手术相关症状及并发症。术后随访6个月,仅1例肝性脑病未得到控制。术后3、6个月谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)及门静脉主干血流速度与术前比较,差异均无统计学意义(P>0.05);术后3、6个月分流道血流速度与术前比较,差异均有统计学意义(P<0.05)。结论MPSE可降低TIPS术后分流道血流速度,起到限流作用,从而有效控制肝性脑病。Objective To observe the effect of modified partial splenic artery embolization(MPSE)in the treatment of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt(TIPS).Methods A retrospective analysis was performed for 10 patients with hepatic encephalopathy after TIPS treated with MPSE.Liver function indexes,main portal vein flow velocity and shunt flow velocity were compared before and 3 and 6 months after operation were compared.Results All patients successfully completed the MPSE,and postoperative symptoms of abdominal pain occurred in 1 case,but no obvious surgery-related symptoms and complications were found in other cases.During the six-month postoperative follow-up,only 1 case of hepatic encephalopathy was not controlled.There were no significant differences in alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),albumin(ALB)and main portal vein blood flow velocity at 3 and 6 months after operation(P>0.05).There were significant differences in shunt flow velocity 3 and 6 months after operation(P<0.05).Conclusion MPSE can reduce the shunt blood flow velocity after TIPS,and has the functions of flow limiting,thereby effectively controlling hepatic encephalopathy.

关 键 词：改良部分性脾动脉栓塞术 经颈静脉肝内门体分流术 肝性脑病 弹簧圈 门体分流道 限流 

分 类 号：R575.5[医药卫生—消化系统] R816.5[医药卫生—内科学]