TIPS治疗27例肝窦阻塞综合征患者近、中期疗效评价  

Evaluation of the efficacy of TIPS in 27 patients with hepatic sinus obstruction syndrome in the near and medium term

作　　者：王磊 张裕 王修琪 岳振东 范振华 吴一凡 刘福全 董健[2] 张珂 蒋力 丁惠国[4] 张月宁[4] Wang Lei;Zhang Yu;Wang Xiuqi;Yue Zhendong;Fan Zhenhua;Wu Yifan;Liu Fuquan;Dong Jian;Zhang Ke;Jiang Li;Ding Huiguo;Zhang Yuening(Department of Interventional Therapy,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Radiology Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Surgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Gastroenterology,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京世纪坛医院介入治疗科,北京100038 [2]首都医科大学附属北京世纪坛医院放射科,北京100038 [3]首都医科大学附属北京地坛医院外科,北京100015 [4]首都医科大学附属北京佑安医院消化科,北京100069

出　　处：《中华肝脏病杂志》2023年第8期842-846,共5页Chinese Journal of Hepatology

基　　金：首都卫生发展科研专项项目(重点攻关-首发2018-1-2081)。

摘　　要：目的:评价经颈静脉肝内门腔静脉分流术(TIPS)治疗肝窦阻塞综合征(HSOS)的近、中期疗效。方法:回顾性分析2018年7月至2020年7月我中心收治的27例HSOS的患者,均行TIPS治疗,观察门静脉压力(PVP)、门静脉压力梯度(PPG)及肝功能变化,从而进行疗效评价。手术前后的计量资料比较采用配对样本t检验,计数资料采用χ2检验,取P<0.05具有统计学意义。结果:27例HSOS患者TIPS术后PVP由分流前的(4.41±0.18)kPa降至分流后的(2.69±0.11)kPa(t=82.41,P<0.001),PPG由分流前(3.23±0.18)kPa降至分流后的(1.46±0.23)kPa(t=32.41,P<0.001),差异均有统计学意义。术后肝功能较术前明显好转。术后随访24个月,3例发生支架再狭窄,经球囊扩张后再通。3例发生肝性脑病,经药物治疗后好转。1例行肝移植。结论:TIPS治疗HSOS近、中期疗效肯定,并可为肝移植患者提供了等待肝源的时间。Objective intrahepatic portocaval shunt(TIPS)in the treatment of hepatic sinusoidal obstruction syndrome(HSOS).Methods A retrospective analysis was performed on 27 patients with HSOS who were treated with TIPS in our center from July 2018 to July 2020.The changes of portal vein pressure(PVP),portal vein pressure gradient(PPG)and liver function were observed,so as to evaluate the efficacy.Paired t test was adopted to evaluate the quantitative parameters,whileχ^(2)test was used to analyze qualitative parameters,with P<0.05 as statistical difference.Results PVP decreased from(4.41±0.18)kPa before shunt to(2.69±0.11)kPa after shunt(t=82.41,P<0.001),PPG decreased from(3.23±0.18)kPa before shunt to(1.46±0.23)kPa after shunt(t=32.41,P<0.001).The liver function improved significantly after operation.After 24 months of follow-up,3 patients developed stent restenosis and recanalized after balloon dilation.Three patients developed hepatic encephalopathy,which was improved after drug treatment.One patient underwent liver transplantation due to liver failure.Conclusion TIPS is effective in the treatment of HSOS in the short and medium term,and can provide time for liver transplantation patients to wait for liver source.

关 键 词：肝窦阻塞综合征 经颈静脉肝内门腔静脉分流术 门静脉高压 治疗 治疗效果 

分 类 号：R657.3[医药卫生—外科学]