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根据巴韦诺 VII 标准进行的肝脏代偿——经颈静脉肝内门体分流术:这是真的吗?

Hepatic recompensation according to the Baveno VII criteria a transjugular intrahepatic portosystemic shunt: Is this true?

作者信息

Zhang Jin-Shan

机构信息

Department of General Surgery, Capital Institute of Pediatrics, Beijing 100020, China.

出版信息

World J Gastrointest Surg. 2024 Aug 27;16(8):2742-2744. doi: 10.4240/wjgs.v16.i8.2742.

Abstract

Hepatic recompensation is firstly described in the Baveno VII criteria, which requires the fulfillment of strict criteria. First, a primary cause of cirrhosis must be addressed, suppressed, or cured. Second, complications of liver cirrhosis, including ascites, encephalopathy, and variceal hemorrhage, must disappear without any intervention. Finally, liver function indicators must be improved. Moreover, without addressing/suppressing/curing cirrhosis and improvement in liver synthetic function, complications, including ascites and variceal hemorrhage can be improved by a transjugular intrahepatic portosystemic shunt (TIPS), which is not evidence of hepatic recompensation. Therefore, on the basis of the definition of hepatic recompensation, TIPS does not achieve hepatic recompensation.

摘要

肝代偿首先在巴韦诺 VII 标准中被描述,这需要满足严格的标准。首先,必须解决、抑制或治愈肝硬化的主要病因。其次,肝硬化的并发症,包括腹水、肝性脑病和静脉曲张出血,必须在没有任何干预的情况下消失。最后,肝功能指标必须得到改善。此外,如果不解决/抑制/治愈肝硬化以及改善肝脏合成功能,包括腹水和静脉曲张出血在内的并发症可以通过经颈静脉肝内门体分流术(TIPS)得到改善,但这并非肝代偿的证据。因此,根据肝代偿的定义,TIPS 并不能实现肝代偿。

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Baveno VII - Renewing consensus in portal hypertension.《巴韦诺 VII 共识:门静脉高压领域的新共识》
J Hepatol. 2022 Apr;76(4):959-974. doi: 10.1016/j.jhep.2021.12.022. Epub 2021 Dec 30.

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