经颈静脉肝内门体分流术治疗肝硬化门静脉高压患者的临床效果观察.docVIP

经颈静脉肝内门体分流术治疗肝硬化门静脉高压患者的临床效果观察 　　【摘要】 目的：探讨经颈静脉肝内门体分流术（Tips）治疗肝硬化门静脉高压患者的临床效果。 　　方法：选择本院消化内科收治的18例行经颈静脉肝内门体分流术治疗的肝硬化门静脉高压患者为研究对象，根据其临床资料进行回顾性分析和总结，观察患者的治疗效果及术后门脉系统血流动力学的变化情况。结果：Tips手术成功率为94.4%，术后患者静脉曲张减轻或消失，腹水减少或消退，全部止血成功。术后显效12例，好转6例，治疗总有效率为100%；术后1年患者分流道狭窄闭塞发生率为16.7%，再出血率为11.1%，肝性脑病发生率为22.2%。治疗后患者门静脉内径、脾静脉内径、门脉血流速度、门脉主干压均较治疗前有显著改善，比较差异有统计学意义（P0.05）。结论：经颈静脉肝内门体分流术治疗肝硬化门静脉高压患者的临床效果显著，能够有效降低门脉压，安全性高，能显著改善患者的生存质量，同时明显减轻患者经济负担，具有较高应用价值，值得推广。 　　【关键词】 颈静脉肝内门体分流术； 肝硬化； 门静脉高压； 临床疗效 　　Transjugular Intrahepatic Portosystemic Shunt for Treatment of Patients with Cirrhotic Portal Hypertension/FENG Xiao-chang.//Medical Innovation of China，2016，13（04）：119-121 　　【Abstract】 Objective： To investigate clinical efficacy of transjugular intrahepatic portosystemic shunt （TIPS） for treatment of patients with cirrhotic portal hypertension. Method： Eighteen patients with cirrhotic portal hypertension admitted by the Gastroenterology Department of the Hospital undergoing TIPS were selected as research candidates， retrospective analysis and summary were conducted according to the clinical data， and treatment efficacy and postoperative change in the hemodynamics of patients’ portal system were observed. Result： Surgical success rate of TIPS was 94.4%， the varicose veins of patients after surgeries decreased or disappeared， ascites reduced or faded away， and hemostasis was all successful. 12 patients were excellent， 　　6 patients were improved after surgeries， and the total effective rate was 100%. The incidence of shunt stenosis and occlusion in one year after treatment was 16.7%， re-hemorrhage rate was 11.1%， and the incidence of hepatic encephalopathy rate was 22.2%. The portal vein diameter， the internal diameter of splenic vein and the portal blood flow velocity and the portal vein pressure of trunk of patients were improved significantly when compared to those indexes before treatment， and the differences were significant （P0.05）. Conclusion： TIPS generates significant efficacy