| 羊丹 张国梁 王凤梅 边芬 贾科峰.PTVE 与TIPS治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血
的疗效比较[J].,2016,16(15):2876-2878 |
| PTVE 与TIPS治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血
的疗效比较 |
| Cirrhotic Portal Hypertension Combined with Esophageal Gastric VaricesBleeding: Comparison of Efficacy of PTVE and TIPS |
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| DOI： |
| 中文关键词: 肝硬化 门静脉高压 经皮胃底曲张静脉栓塞术 经颈静脉肝内门体分流术 |
| 英文关键词: Liver cirrhosis Portal hypertension Percutaneous transhepatic varices embolization Transjugular intrahepatic portosystemic
shunt |
| 基金项目: |
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| 中文摘要: |
| 目的：研究经皮胃底曲张静脉栓塞术（PTVE）和经颈静脉肝内门体分流术（TIPS）治疗肝硬化门静脉高压合并食管胃底静脉
曲张破裂出血的临床疗效，为临床治疗提供依据。方法：选取2001 年4 月到2015 年4 月我院肝硬化门静脉高压合并食管胃底静
脉曲张破裂患者169 例，根据手术方式分为PTVE 组（行PTVE 治疗）141 例和TIPS 组（行TIPS 治疗）28 例，比较两组术前、术后
门静脉压力，术前、术后3 个月、6 个月以及1 年两组Child-Pugh 评分、白蛋白以及直接胆红素，并比较两组再出血和肝性脑病发
生率。结果：TIPS组术后门静脉压力较术前显著降低，比较差异具有统计学意义（P＜ 0.05），术后PTVE组及TIPS组组间比较差
异具有统计学意义（P＜0.05）；两组术前和术后各时间直接胆红素无统计学意义（P＞0.05）；PTVE组术后1 年白蛋白水平显著升
高，与术前和TIPS 组比较差异具有统计学意义（P＜0.05），TIPS 组术后白蛋白有所升高，但各时间比较差异无统计学意义（P＞
0.05），PTVE 组术后各时间Child-Pugh 评分较术前明显改善，比较差异具有统计学意义（P＜0.05），TIPS组术后3 个月和术后6
个月Child-Pugh 评分较术前明显改善，比较差异具有统计学意义（P＜0.05）；两组术后再出血发生率比较无统计学意义（P＞
0.05），PTVE 组肝性脑病发生率显著低于TIPS组，比较差异具有统计学意义（P＜0.05）。结论：PTVE 和TIPS 治疗肝硬化门静脉
高压合并食管胃底静脉曲张破裂出血效果相当，TIPS 能显著降低门静脉压，PTVE 能降低肝性脑病的发生率，改善患者
Child-Pugh 评分。 |
| 英文摘要: |
| Objective:To study the efficacy of percutaneous transhepatic varices embolization (PTVE) and transjugular
intrahepatic portasystemic shunt (TIPS) in treatment of cirrhotic portal hypertension combined with esophageal gastric varices bleeding,
and to provide the basis for clinical treatment.Methods:A total of 169 patients with cirrhosis portal hypertension combined with
esophageal gastric varices bleeding, who were admitted to The first clinical college of Tianjin Medical University from April 2001 to
April 2015, were selected and divided into PTVE group(treated with PTVE) with 141 patients and TIPS group(treated with TIPS) with 28
patients according to the operation mode. The portal pressure before and after operation, the Child-Pugh score, albumin and direct
bilirubin before operation, 3 months, 6 months and 1 year after operation of the two groups, and the incidence of recurrent hemorrhage
and hepatic encephalopathy between the two groups were compared.Results:The portal pressure of TIPS group significantly decreased
compared with before operation, the difference was statistically significant (P<0.05); the differences after operation between PTVE and
TIPS groups were statistically significant (P<0.05). The differences of the direct bilirubin before and after operation had no significance
(P>0.05). The level of albumin in PTVE group significantly increased 1 year after operation, the difference was statistically significant
compared with before operation and TIPS group (P<0.05); the level of albumin in TIPS group increased after operation, but there was no
significance between each time(P>0.05). The Child-Pugh score after operation of PTVE group was significantly improved compared with
before operation, the difference was statistically significant (P<0.05); the Child-Pugh scores in TIPS group 3 months and 6 months after operation were significantly improved compared with before operation, the differences were statistically significant (P<0.05). The
incidence of recurrent hemorrhage of two groups after operation had no significance(P>0.05). The incidence of hepatic encephalopathy in
PTVE group was significantly lower than that in TIPS group, the difference was statistically significant (P<0.05).Conclusion:PTVE and
TIPS in the treatment of cirrhosis portal hypertension complicated with esophageal gastric varices bleeding had better effects. TIPS can
significantly reduce portal pressure; PTVE can reduce the incidence of hepatic encephalopathy, and improve Child-Pugh scores of the
patients. |
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