You Li-ying, Li Ying-chun, Yan Dong, Xu Ying, Yang Jing, Yang Li-hong, Cheng Fang, Yang Jin-hui
Department of Hepatobiliary Pancreatic Medicine, The 2nd Hospital of Kunming Medical University, Kunming, China.
Zhonghua Gan Zang Bing Za Zhi. 2011 Jul;19(7):490-3. doi: 10.3760/cma.j.issn.1007-3418.2011.07.006.
To investigate the effects of transjugular intrahepatic portosystemic stent-shunt (TIPS) in emergency treatment of esophagogastric varices bleeding for the cirrhosis patients.
39 cases with esophageal and gastric varices bleeding due to liver cirrhosis received TIPS and were followed-up for 1 to 12 months, the short-term effects including 24 hours haemostasis rates post TIPS, pressure gradient between portal vein and systemic circulation, average pressure of portal vein were observed. The levels of albumin, cholinesterase, total bilirubin and prothrombin time post TIPS were also evaluated were observed and evaluated.
37 cases received TIPS successfully among the 39 patients, with a total effective rate of 94.87% (37/39) and the rate of hemostasis in 24 hours was 100%. PSG dropped from (30.44+/-7.68) cm H2O to (18.78+/-4.71) cm H2O, mean portal pressure declined from (38.22+/-7.40) cm H2O to (27.00+/-5.38) cm H2O (P is less than 0.01). No significant differences existed at the level of albumin(A) and cholinesterase (CHE) before and after operation (P is more than 0.05). The relapse rate of frame stenosis was 5.71% (2/35). The incidence rate of hepatic encephalopathy was 13.51% (5/37). The relapse rate of rehaemorrhagia was 2.86% (1/35). The incidence rate of hepatic failure was 2.70% (1/37). The death rate was 5.71% (2/35).
The effect of TIPS in treating portal hypertension caused by liver cirrhosis is prominent and safe, and is worthy of clinical application.
探讨经颈静脉肝内门体分流术(TIPS)对肝硬化患者食管胃静脉曲张破裂出血的急诊治疗效果。
39例肝硬化致食管胃静脉曲张破裂出血患者接受TIPS治疗,并随访1至12个月,观察TIPS术后24小时止血率、门静脉与体循环压力梯度、门静脉平均压力等近期疗效。同时观察并评估TIPS术后白蛋白、胆碱酯酶、总胆红素及凝血酶原时间水平。
39例患者中37例成功接受TIPS治疗,总有效率为94.87%(37/39),24小时止血率为100%。门静脉与体循环压力梯度(PSG)由(30.44±7.68)cmH₂O降至(18.78±4.71)cmH₂O,门静脉平均压力由(38.22±7.40)cmH₂O降至(27.00±5.38)cmH₂O(P<0.01)。术后白蛋白(A)和胆碱酯酶(CHE)水平与术前比较差异无统计学意义(P>0.05)。支架狭窄复发率为5.71%(2/35)。肝性脑病发生率为13.51%(5/37)。再出血复发率为2.86%(1/35)。肝衰竭发生率为2.70%(1/3)。死亡率为5.71%(2/35)。
TIPS治疗肝硬化门静脉高压效果显著且安全,值得临床应用。