本文關(guān)鍵詞：31例行經(jīng)頸靜脈肝內(nèi)門體分流術(shù)患者臨床特點(diǎn)分析并文獻(xiàn)復(fù)習(xí)　出處：《重慶醫(yī)學(xué)》2016年07期 　論文類型：期刊論文

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【摘要】：目的探討分析行經(jīng)頸靜脈肝內(nèi)門體分流術(shù)(transjugular intrahepatic portosystemic shunt,TIPS)患者的臨床特點(diǎn),為臨床開展TIPS提供參考。方法回顧性分析昆明醫(yī)科大學(xué)第二附屬醫(yī)院2009年1月至2014年5月31例接受TIPS治療并嚴(yán)格隨訪復(fù)查患者的臨床資料,統(tǒng)計(jì)并分析患者術(shù)前基本情況、實(shí)驗(yàn)室指標(biāo)、術(shù)后再出血發(fā)生率、手術(shù)并發(fā)癥、抗凝藥物服用情況和血栓形成、溶解情況等。結(jié)果在所有行TIPS患者的診斷中,慢性乙型病毒性肝炎肝硬化并食管胃底靜脈曲張破裂出血、慢性丙型病毒性肝炎肝硬化并食管胃底靜脈出血、酒精性肝硬化并食道胃底靜脈曲張破裂出血、不明原因肝硬化并食管胃底靜脈曲張破裂出血、布加綜合征、慢性乙型并丙型病毒性肝炎肝硬化并食管胃底靜脈出血、原發(fā)性膽汁性肝硬化并食管胃底靜脈曲張破裂出血所占比例分別為45.16%、16.13%、12.90%、12.90%、6.45%、3.22%、3.22%;術(shù)后6個(gè)月內(nèi)再出血發(fā)生率為9.68%;術(shù)前、術(shù)后1周、3個(gè)月、6個(gè)月的平均Child-Puhg評(píng)分分別為(8.35±2.52)、(8.32±1.76)、(9.29±2.55)、(8.10±1.85)分,術(shù)后1周、3個(gè)月、6個(gè)月分別與術(shù)前比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后3個(gè)月肝功能Child-Puhg評(píng)分高于術(shù)后1周、術(shù)后6個(gè)月(P0.05);手術(shù)并發(fā)癥腹腔出血、肝性腦病、支架狹窄發(fā)生率分別為3.22%、22.58%、12.90%;術(shù)后未服用抗凝藥物、服用阿司匹林、服用氯吡格雷、服用華法林的比例分別為9.68%、38.71%、41.94%、9.68%;術(shù)后門脈血栓的形成(包括血栓增多)率為12.90%,血栓溶解率為100%。結(jié)論在我國(guó),肝硬化并門靜脈高壓患者是TIPS的主要來(lái)源,而乙型肝炎是引起肝硬化的主要病因;TIPS對(duì)肝功能Child-Puhg評(píng)分無(wú)明顯影響;肝性腦病、支架狹窄仍然為TIPS術(shù)后主要并發(fā)癥;規(guī)律服用抗凝藥物可以溶解門靜脈血栓和防止血栓形成。
[Abstract]:Objective to investigate the analysis of transjugular intrahepatic portosystemic shunt (transjugular intrahepatic portosystemic shunt, TIPS) the clinical characteristics of the patients, to provide reference for clinical development of TIPS. Methods: a retrospective analysis of the Second Affiliated Hospital of Kunming Medical University from January 2009 to May 2014, 31 patients received TIPS treatment and follow-up of patients with strict clinical data, statistics and analysis of the basic situation of patients before operation, laboratory index, rebleeding rate, postoperative complications, anticoagulation drugs and thrombosis, dissolved condition. Results in all TIPS patients in the diagnosis of chronic hepatitis B cirrhosis and esophageal variceal bleeding, chronic hepatitis C cirrhosis and esophageal variceal bleeding. Alcoholic cirrhosis and esophageal variceal bleeding, unexplained cirrhosis and esophageal and gastric varices rupture 瑁傚嚭琛，

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