经颈静脉肝内门体分流术对门静脉高压和肝肺综合征患者肺气体交换的影响。
Effect of transjugular intrahepatic portosystemic shunt on pulmonary gas exchange in patients with portal hypertension and hepatopulmonary syndrome.
作者信息
Martinez-Palli Graciela, Drake Britt B, Garcia-Pagan Joan-Carles, Barbera Joan-Albert, Arguedas Miguel R, Rodriguez-Roisin Robert, Bosch Jaume, Fallon Michael B
机构信息
Servei d'Anestesiologia i Reanimacio Hospital Clinic, Institut d'Investigacions Biomediques august Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
出版信息
World J Gastroenterol. 2005 Nov 21;11(43):6858-62. doi: 10.3748/wjg.v11.i43.6858.
AIM
To assess the impact of transjugular intrahepatic portosystemic shunt (TIPS) on pulmonary gas exchange and to evaluate the use of TIPS for the treatment of hepatopulmonary syndrome ( HPS ).
METHODS
Seven patients, three of them with advanced HPS, in whom detailed pulmonary function tests were performed before and after TIPS placement at the University of Alabama Hospital and at the Hospital Clinic, Barcelona, were considered.
RESULTS
TIPS patency was confirmed by hemodynamic evaluation. No changes in arterial blood gases were observed in the overall subset of patients. Transient arterial oxygenation improvement was observed in only one HPS patient, early after TIPS, but this was not sustained 4 mo later.
CONCLUSION
TIPS neither improved nor worsened pulmonary gas exchange in patients with portal hypertension. This data does not support the use of TIPS as a specific treatment for HPS. However, it does reinforce the view that TIPS can be safely performed for the treatment of other complications of portal hypertension in patients with HPS.
目的
评估经颈静脉肝内门体分流术（TIPS）对肺气体交换的影响，并评估TIPS在治疗肝肺综合征（HPS）中的应用。
方法
纳入了7例患者，其中3例为晚期HPS患者，他们在阿拉巴马大学医院和巴塞罗那医院诊所接受了TIPS植入术，术前和术后均进行了详细的肺功能测试。
结果
通过血流动力学评估证实了TIPS的通畅性。在整个患者亚组中未观察到动脉血气的变化。仅1例HPS患者在TIPS术后早期出现了短暂的动脉氧合改善，但4个月后未持续。
结论
TIPS对门静脉高压患者的肺气体交换既没有改善也没有恶化。该数据不支持将TIPS作为HPS的特异性治疗方法。然而，这确实强化了这样一种观点，即对于HPS患者，TIPS可安全用于治疗门静脉高压的其他并发症。
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