经颈静脉肝内门腔分流术治疗血吸虫性肝硬化门脉高压征临床分析

发布时间：2018-03-24 08:10

  本文选题：手术　切入点：血吸虫　出处：《中国地方病防治杂志》2017年06期

【摘要】：目的探讨分析经颈静脉肝内门腔分流术治疗血吸虫性肝硬化门脉高压征疗效。方法选择2010年3月至2016年3月本院收治的血吸虫性肝硬化门静脉高压征患者58例,采用经颈静脉肝内门腔分流术(TIPS)治疗,观察手术临床疗效,并比较分析患者手术前后门脉压力、门脉压力梯度变、血清生化指标变化。结果本组58例患者中,均成功置入支架建立分流道,手术成功率为100.00%,随访期内,无患者死亡;患者术后门脉压力及门脉压力梯度均较术前显著降低(P0.05);患者手术前后血小板计数、红细胞计数、天冬氨酸转氨酶、丙氨酸转氨酶、血清肌酐、尿素氮以及总胆红素水平均有显著差异(P0.05);术后门脉压力降低幅度0~25%患者肝性脑病发生率显著高于门脉压力降低幅度≥25%患者(P0.05);术后门脉压力降低幅度与支架狭窄发生率无明显相关(P0.05)。结论经颈静脉肝内门腔分流术治疗血吸虫性肝硬化门脉高压征具有着显著的临床疗效,能够有效降低降低机体门脉压力及门脉压力梯度,并改善患者机体生化指标,而术后门脉压力降低幅度越低,术后肝性脑病发生率越高。
[Abstract]:Objective to investigate the curative effect of portal cavity shunt through jugular vein in the treatment of portal hypertension syndrome of schistosomiasis cirrhosis. Methods 58 patients with portal hypertension syndrome of schistosomiasis cirrhosis were selected from March 2010 to March 2016. Transjugular intrahepatic portal shunt (TIPS) was used to observe the clinical efficacy of the operation, and to compare and analyze the changes of portal pressure, portal pressure gradient and serum biochemical indexes before and after operation. The successful rate of operation was 100.00. no patient died during the follow-up period, the portal pressure and portal pressure gradient after operation were significantly lower than those before and after operation (P 0.05), the platelet count and erythrocyte count before and after operation. Aspartate transaminase, alanine aminotransferase, serum creatinine, There were significant differences in urea nitrogen and total bilirubin levels (P 0.05), the incidence of hepatic encephalopathy in patients with postoperative portal pressure reduction of 0% or 25% was significantly higher than that in patients with more than 25% reduction in portal pressure, and the extent of portal pressure reduction and stent stenosis after operation was significantly higher than that in patients with portal vein pressure 鈮，

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