【摘要】：目的：探討經(jīng)門靜脈左支與右支的TIPS術(shù)治療肝硬化合并門靜脈高壓患者的療效。 方法：64例患者按入院先后順序進行編號后，單號分配到TIPS-LBPV組（共32例,其中2名患者操作失敗）、雙號分配到TIPS-RBPV組（共32例）。62例患者術(shù)后隨訪1年。實驗中34例患者分別抽取門靜脈左、右支的血，檢測血氨濃度，，并進行統(tǒng)計學比較。 結(jié)果：門靜脈左支血氨濃度低于門靜脈右支（p=0.01）。兩種術(shù)式在降低門靜脈壓力方面的效果類似（p㧐0.05）。TIPS-LBPV組術(shù)后肝性腦病的發(fā)生率低于TIPS-RBPV組（p=0.036）。TIPS-LBPV組術(shù)后支架功能異常的發(fā)生率也低于TIPS-RBPV組（p=0.042）。 結(jié)論：門靜脈左支的血氨濃度低于門靜脈右支，行TIPS-LBPV術(shù)的患者術(shù)后肝性腦病及支架功能異常的發(fā)生率低于接受TIPS-RBPV術(shù)的患者。
[Abstract]:Objective: to evaluate the efficacy of TIPS in the treatment of cirrhotic patients with portal hypertension. Methods: 64 patients were assigned to TIPS-LBPV group (32 cases) and even number group (32 cases) to TIPS-RBPV group. 62 patients were followed up for 1 year. Blood samples from left and right branches of portal vein were collected from 34 patients, and blood ammonia concentrations were measured and compared statistically. Results: the concentration of ammonia in the left branch of portal vein was lower than that in the right branch of portal vein (p0. 01). The incidence of hepatic encephalopathy in TIPS-LBPV group was lower than that in TIPS-RBPV group (p0. 036). The incidence of abnormal stent function in TIPS-LBPV group was also lower than that in TIPS-LBPV group. It was lower than that in TIPS-RBPV group (p0. 042). Conclusion: the concentration of ammonia in the left branch of portal vein is lower than that in the right branch of portal vein. The incidence of hepatic encephalopathy and abnormal stenting in TIPS-LBPV patients is lower than that in TIPS-RBPV patients.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R575.2

【參考文獻】

相關(guān)期刊論文 前5條

1 褚建國,樸龍松,陳肇一,黃卓英,徐家興;家兔門靜脈系統(tǒng)不同部位血氨濃度比較的前瞻性研究[J];介入放射學雜志;1999年01期

2 陳發(fā)玉;朱家勝;;TIPSS治療門靜脈高壓癥進展[J];遼寧醫(yī)學院學報;2011年06期

3 諸建國,樸龍松,陳肇一,黃鶴,呂春燕,徐家興,孫曉麗;門靜脈左支分流降低術(shù)后肝性腦病的臨床研究[J];中華肝臟病雜志;2002年06期

4 王宇明;肝性腦病的定義、命名和診斷[J];中華肝臟病雜志;2004年05期

5 Hauke S Heinzow;Philipp Lenz;Michael K銉hler;Frank Reinecke;Hansj銉rg Ullerich;Wolfram Domschke;Dirk Domagk;Tobias Meister;;Clinical outcome and predictors of survival after TIPS insertion in patients with liver cirrhosis[J];World Journal of Gastroenterology;2012年37期

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