TIPS术对肝硬化门脉高压患者营养状况的影响
发布时间：2018-09-05 15:56
【摘要】：目的:探究肝硬化失代偿期患者营养状况水平,了解经颈静脉肝内门体静脉分流术(Transjugular Intrahepatic Portosystemic Shunt,TIPS)术后肝硬化患者的营养状况是否发生改变,以及TIPS术后发生肝性脑病(Hepatic Encephalopathy,HE)的患者与未发生HE的患者的人体成分是否存在差异。方法:本次研究最终符合入组要求的患者共58例。采集入组患者TIPS术前、术后的生物电阻抗分析(Bioelectrical Impedance Analysis,BIA)结果,电话随访每一位患者术后一般情况及是否出现HE表现。应用配对t检验对完成术前、术后BIA检查的患者进行人体成分差异显著性分析;应用独立样本t检验,检验发生HE组患者营养状况与未发生HE组患者的营养状况是否存在显著性差异。结果:(1)22例患者完成了术后第1个月的BIA人体成分分析,术后患者的腰臀比(0.82土0.04VS0.85±0.05,P0.001)较术前均显著下降。(2)20例患者完成了术后第3个月的BIA人体成分分析,术后患者的肌肉量(43.26±8.79 VS45.19土8.89Kg,P=0.012),去脂体重(45.98土9.26 VS47.92士9.33Kg,P=0.018),蛋白质(8.87±1.83 VS 9.23±1.88Kg,P=0.016),骨骼肌(24.79±5.55 VS 25.86 土 5.66Kg,P=0.019),BCM(29.44± 6.08 VS 30.59 ±6.21Kg,P=0.023)较术前均有显著改善。(3)14例患者完成了术后第6个月的BIA检查,术后患者除肌肉量(P0.001),去脂体重(P0.001),蛋白质(P0.001),骨骼肌(P0.001),BCM(P0.001)有显著增加外,上臂周长(29.05±2.56VS30.29±2.24cm,P=0.012),上臂去脂周长(23.91±2.27VS25.23±2.23cm,P0.001)的增加也具有显著性。(4)TIPS术后HE组与未发生HE组两组之间的人体成分差异不存在统计学意义。结论:(1)肝硬化失代偿期患者TIPS术后营养状况有改善。(2)本研究中,发生肝性脑病的患者与未发生肝性脑病的患者在人体成分方面不存在显著差异。
[Abstract]:Objective: To investigate the nutritional status of patients with decompensated cirrhosis, and to understand whether the nutritional status of patients with cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) has changed, and whether the patients with hepatic encephalopathy (HE) and those without HE have occurred after TIPS. Methods: A total of 58 patients were enrolled in this study. Bioelectrical Impedance Analysis (BIA) was performed before and after TIPS. The general condition and HE appearance of each patient were followed up by telephone. Results: (1) 22 patients completed the body composition analysis of BIA at the first month after surgery, and the waist-to-hip ratio was 0. 82 soil 0.04 VS 0.85 (+ 0.05), P 0.001) were significantly lower than those before surgery. (2) 20 patients completed the BIA body composition analysis at the third month after surgery. The postoperative muscle mass (43.26 (+ 8.79 VS 45.19 soil 8.89 Kg, P = 0.012), fat-free weight (45.98 soil 9.26 VS 47.92 s 9.33 Kg, P = 0.018), protein (8.87 (+ 1.83 VS 9.23 (+ 1.88 Kg, P = 0.016), skeletal muscle mass (24.79 (+ 5.79). 5 VS 25.86 clay 5.66 Kg, P = 0.019, BCM (29.44 + 6.08 VS 30.59 + 6.21 Kg, P = 0.023) were significantly improved compared with preoperative. (3) Fourteen patients completed the BIA examination at the 6th month after surgery, except muscle mass (P 0.001), fat-free weight (P 0.001), protein (P 0.001), skeletal muscle (P 0.001), and BCM (P 0.001), the circumference of the upper arm (29.05 + 2.56V) increased significantly. There was no significant difference in body composition between HE group and non-HE group after TIPS. Conclusion: (1) The nutritional status of patients with decompensated cirrhosis after TIPS was improved. (2) In this study, hepatic encephalopathy occurred. There was no significant difference in body composition between patients with disease and those without hepatic encephalopathy.
【学位授予单位】：东南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2
本文编号：2224752
[Abstract]:Objective: To investigate the nutritional status of patients with decompensated cirrhosis, and to understand whether the nutritional status of patients with cirrhosis after transjugular intrahepatic portosystemic shunt (TIPS) has changed, and whether the patients with hepatic encephalopathy (HE) and those without HE have occurred after TIPS. Methods: A total of 58 patients were enrolled in this study. Bioelectrical Impedance Analysis (BIA) was performed before and after TIPS. The general condition and HE appearance of each patient were followed up by telephone. Results: (1) 22 patients completed the body composition analysis of BIA at the first month after surgery, and the waist-to-hip ratio was 0. 82 soil 0.04 VS 0.85 (+ 0.05), P 0.001) were significantly lower than those before surgery. (2) 20 patients completed the BIA body composition analysis at the third month after surgery. The postoperative muscle mass (43.26 (+ 8.79 VS 45.19 soil 8.89 Kg, P = 0.012), fat-free weight (45.98 soil 9.26 VS 47.92 s 9.33 Kg, P = 0.018), protein (8.87 (+ 1.83 VS 9.23 (+ 1.88 Kg, P = 0.016), skeletal muscle mass (24.79 (+ 5.79). 5 VS 25.86 clay 5.66 Kg, P = 0.019, BCM (29.44 + 6.08 VS 30.59 + 6.21 Kg, P = 0.023) were significantly improved compared with preoperative. (3) Fourteen patients completed the BIA examination at the 6th month after surgery, except muscle mass (P 0.001), fat-free weight (P 0.001), protein (P 0.001), skeletal muscle (P 0.001), and BCM (P 0.001), the circumference of the upper arm (29.05 + 2.56V) increased significantly. There was no significant difference in body composition between HE group and non-HE group after TIPS. Conclusion: (1) The nutritional status of patients with decompensated cirrhosis after TIPS was improved. (2) In this study, hepatic encephalopathy occurred. There was no significant difference in body composition between patients with disease and those without hepatic encephalopathy.
【学位授予单位】：东南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.2
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