经颈静脉肝内门体支架分流术治疗肝硬化顽固性腹腔积液患者疗效分析.pdf

《经颈静脉肝内门体支架分流术治疗肝硬化顽固性腹腔积液患者疗效分析.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、主兰堡苤查!皇2201旦箜鲞箜塑!墨(垦!!Ic里堕on)，Februar—y20—14,Vo1．4，No．1．9．．临床研究．经颈静脉肝内门体支架分流术治疗肝硬化顽固性腹腔积液患者疗效分析蒋明珊罗薛峰李肖【摘要】目的分析经颈静脉肝内门体支架分流术(TIPS)治疗肝硬化顽固性腹腔积液的疗效。方法回顾性分析四川华西医院2012年1—12月31例因肝硬化合并顽固性腹腔积液行rIPS治疗的患者，评估腹腔积液缓解率、TIPS并发症和远期预后。应用Cox模型单因素分析筛选腹腔积液缓解的危险因素；Cox模型单因素分析提示有统计学意义的因素纳入Cox模型多因

2、素分析。结果31例患者均成功接受支架植入，操作成功率100％。平均随访(9．4±3．1)个月，术后1个月、6个月腹腔积液完全缓解率分别为19％(6／31)和71％(22／31)。多因素分析显示TIPS术前Child-push评分是腹腔积液完全缓解的独立预测因子(相对危险度0．275，95％C10．037～0．716，P=0．012)。结论TIPS可有效缓解肝硬化顽固性腹腔积液，同时未明显增加手术并发症。【关键词】肝硬化；腹腔积液；经颈静脉肝内门体支架分流术Clinicaleficacyoftransjugularintrahepaticport

3、osystemicshuntforrefractoryasdtescausedbycirrhosisJiangMingshan，Xuefeng，LiXiao．DepartmentofGastroenterology，￡ChinaHospital，SwhuanUnive~ity．Chengdu6loo4l。ChinaCorrespondingauthor：LiXiao．Email：simonlixiao@gmail．eom【Abstract】0bjectiveToevaluatetheeffectoftransjugularintrahepati

4、cportosystemicshunt(TIPS)oncirrhoticpatientswithrefractoryaseites．MethodsFromJanuary2012toDeeember2012．31cirhoticpatientswhounderwentTIPSprocedureduetorefractoryascitesinWestChinaHospitalofSichuanUniversitywereincludedandevaluatedretrospectively．Remissionratesofascites．compl

5、icationsandlong．termprognosiswereanalyzed．Riskfactorsofascitesremissionweremono—factoranalyzedusingCoxmodel，andmultivariateanalysiswasusedforthestatisticalsignificantvariables．ResultsTechnicalsuccessrateofTIPSprocedurewas100％(31／31)．Themeanfollow—uptimewas(9．4±3．1)months．Com

6、pleteresponserateswere19％(6／31)and7l％(22／31)in1and6monthsaftertheoperation．MuhivariateanalysisshowedthatpreoperativeChild．pughscorewastheindependentpredictorforascitescompleteremissionIrelativerisk(RR)0．275，95％C／0．037-0．716．P=0．012I．ConclusionTIPSCaneffectivelyrelieverefract

7、oryascitesofcirrhoticpatients．butnotincreasetheincidenceofsurgicalcomplicationsobviously．【Keywords】Livercirhosis；Ascites；Transjugularintrahepaticportosystemicshunt顽固性腹腔积液是常见的肝硬化门静脉高压并发主要障碍。有学者认为选择直径68mm支架症，在肝硬化腹腔积液患者中发病率约为10％，1年生可减少术后肝性脑病发生，改善患者生活质量。存率仅为25％～50％[1-2]。顽固性腹腔积液常

8、见的治本研究拟分析TIPS治疗肝硬化顽固性腹腔积液患疗手段包括腹腔穿刺大量放液、经颈静脉肝内门体支者的疗效。架分流术(transjugularintr