经颈静脉肝内门体分流术中联合侧支血管栓塞治疗肝硬化食管胃静脉曲张出血的应用进展与争议  

Transjugular intrahepatic portosystemic shunt combined with collateral vessel embolization in treatment of gastroesophageal variceal bleeding in liver cirrhosis: Research advances and controversies

作　　者：吴琼 赵连晖 王广川 张春清 WU Qiong;ZHAO Lianhui;WANG Guangchuan;ZHANG Chunqing(Department of Gastroenterology,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China;Department of Infectious Diseases,Qilu Hospital,Shandong University,Jinan 250021,China)

机构地区：[1]山东第一医科大学附属省立医院消化内科,济南250021 [2]山东大学齐鲁医院感染科,济南250021

出　　处：《临床肝胆病杂志》2023年第10期2460-2463,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81970533);山东省自然科学基金(ZR2022ZD21)。

摘　　要：经颈静脉肝内门体分流术(TIPS)在国内外指南中被推荐用于肝硬化门静脉高压并发症的治疗,但其在疗效方面仍存在不确定性。越来越多的研究发现TIPS中联合侧支血管栓塞术(TIPS+E)治疗肝硬化门静脉高压食管胃静脉曲张出血具有一定优势。本文归纳了目前国内外TIPS+E的主要研究,总结了该技术现阶段的指南推荐情况及临床应用现状等,并提出了其适应证、血流动力学标准和栓塞材料选择等亟待解决的问题,未来仍需大样本量、多中心随机对照研究进一步明确。Transjugular intrahepatic portosystemic shunt(TIPS)has been recommended as a treatment method for cirrhotic portal hypertension in domestic and foreign guidelines,but there is still uncertainty in its therapeutic efficacy.More and more studies have shown that TIPS combined with collateral vessel embolization(TIPS+E)has certain advantages in the treatment of gastroesophageal variceal bleeding in liver cirrhosis.This article reviews the major studies on TIPS+E in China and globally,summarizes related recommendations in guidelines and the current status of clinical application,and proposes the issues that need to be solved,such as indication,hemodynamic criteria,and selection of materials for embolization,and large-sample multicenter randomized controlled trials are needed for further clarification.

关 键 词：肝硬化 食管和胃静脉曲张 门体分流术 经颈静脉肝内 栓塞 治疗性 

分 类 号：R575.2[医药卫生—消化系统]