Jalan R, Dabos K, Redhead D N, Lee A, Hayes P C
Centre for Liver and Digestive Disorders, and Department of Medicine, Royal Infirmary of Edinburgh, Scotland, UK.
J Hepatol. 1997 Nov;27(5):928-33. doi: 10.1016/s0168-8278(97)80333-9.
Increased intracranial pressure and cerebral oedema in patients with chronic liver disease is rare and is more typical of acute liver failure. Transjugular intrahepatic portosystemic stent-shunt is being increasingly used in the management of uncontrolled variceal haemorrhage in patients with cirrhosis. In our institution, a total of 160 patients has undergone transjugular intrahepatic porto-systemic stent-shunt for variceal haemorrhage; 56 of these procedures were emergencies for uncontrolled variceal haemorrhage. Four of these 56 patients developed features of acute liver failure, with marked deterioration in liver function tests and elevated intracranial pressure. This unusual but important complication of transjugular intrahepatic portosystemic stent-shunt has not been reported in the literature previously, and may have important consequences both for clinical practice and in the provision of further clues to understanding the pathogenesis of increased intracranial pressure in patients with liver diseases.
慢性肝病患者出现颅内压升高和脑水肿的情况较为罕见，更常见于急性肝衰竭患者。经颈静脉肝内门体分流术（TIPS）在肝硬化患者难治性静脉曲张出血的治疗中应用越来越广泛。在我们机构，共有160例患者接受了经颈静脉肝内门体分流术治疗静脉曲张出血；其中56例手术是针对难治性静脉曲张出血的紧急情况。这56例患者中有4例出现了急性肝衰竭的症状，肝功能检查明显恶化且颅内压升高。经颈静脉肝内门体分流术这种不寻常但重要的并发症此前在文献中尚未有报道，它可能对临床实践以及进一步理解肝病患者颅内压升高的发病机制提供重要线索都产生重要影响。
