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经颈静脉肝内门体分流术联合 AngioJet 血栓切除术治疗非肝硬化急性门静脉血栓的临床研究。

Clinical study of transjugular intrahepatic portosystemic shunt combined with AngioJet thrombectomy for acute portal vein thrombosis in non-cirrhosis.

机构信息

Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou.

Department of Interventional Radiology, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, China.

出版信息

Medicine (Baltimore). 2021 Feb 12;100(6):e24465. doi: 10.1097/MD.0000000000024465.

DOI:10.1097/MD.0000000000024465
PMID:33578540
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7886424/
Abstract

To evaluate the outcomes of the transjugular intrahepatic portosystemic shunt (TIPS) combined with AngioJet thrombectomy in patients with noncirrhotic acute portal vein (PV) thrombosis.Retrospective analysis from January 2014 to March 2017, 23 patients underwent TIPS combined with AngioJet thrombectomy for acute PV thrombosis in noncirrhosis. The rates of technical success, the patency of the PV, liver function changes, and complications were evaluated.Twenty-three patients underwent combined treatment, with a technical success rate of 100%. Twenty-four hours after treatment, PV thrombosis grade was improved significantly (P = .001). Before and after treatment, Albumin (gm/dl), aspartate transaminase (IU/l), alanine transaminase (IU/l), and platelets (109/L) were all significantly improved (P < .05). Minor complications include hematoma, hematuria, and hepatic encephalopathy. After 1 week of treatment, computed tomography scan revealed 8.7% (2/23) cases of hepatic envelope hematoma (thickness less than 2 cm). Hemoglobinuria occurred in 18/23 (78.3%) patients after treatment and returned to normal within 1 to 2 days. Two patients 2/23 (8.7%) had transient grade I encephalopathy after TIPS. The 1-year overall survival rate was 100% (23/23). No major complications during treatment in all patientsAngioJet thrombectomy via TIPS has a favorable short-term effect in clearing thrombus and alleviating symptoms in diffuse acute PVT. The long-term efficacy of this treatment needs to be further studied.

摘要

目的

评估经颈静脉肝内门体分流术(TIPS)联合 AngioJet 血栓切除术治疗非肝硬化性急性门静脉(PV)血栓形成的疗效。

方法

回顾性分析 2014 年 1 月至 2017 年 3 月 23 例因非肝硬化性急性 PV 血栓形成而行 TIPS 联合 AngioJet 血栓切除术的患者资料。评估技术成功率、PV 通畅率、肝功能变化及并发症发生情况。

结果

23 例患者均成功接受联合治疗,技术成功率为 100%。治疗后 24 h 门静脉血栓分级显著改善(P = .001)。治疗前后白蛋白(gm/dl)、天冬氨酸转氨酶(IU/l)、丙氨酸转氨酶(IU/l)和血小板(109/L)均明显改善(P < .05)。术后轻微并发症包括血肿、血尿和肝性脑病。治疗后 1 周行 CT 扫描,8.7%(2/23)患者出现肝包膜血肿(厚度<2 cm)。23 例患者中有 18 例(78.3%)术后发生血红蛋白尿,1~2 d 内恢复正常。2 例(8.7%)患者 TIPS 术后出现短暂性 I 级脑病。1 年总生存率为 100%(23/23)。

结论

TIPS 联合 AngioJet 血栓切除术治疗弥漫性急性 PVT 可迅速清除血栓,缓解症状,短期疗效良好。该治疗方法的长期疗效有待进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b11/7886424/251ac84ff198/medi-100-e24465-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b11/7886424/5012e44d35c8/medi-100-e24465-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b11/7886424/251ac84ff198/medi-100-e24465-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b11/7886424/5012e44d35c8/medi-100-e24465-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b11/7886424/251ac84ff198/medi-100-e24465-g002.jpg

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