资源描述：
《内镜下硬化治疗联合干细胞移植及TIPS手术治疗终末期肝病》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、内镜下硬化治疗联合干细胞移植及TIPS手术治疗终末期肝病王军，樊丽琳，兰春慧，杨均，颜棊先，肖潇，李丽，胡辂，李娅，杨敏，李平，赵蓉，崔红利，彭安国，李清，何燕，周世亮，王斌，陈东风(400042,重庆，第三军医大学大坪医院野战外科研究所消化内科)［摘要］目的探讨针对失代偿期肝便化的两大临床表现即肝功能严重受损及门脉高压并发症的综合序贯治疗方案。方法选取2009年6月至2011年8月收治的22例失代偿期肝硬化患者，child分级B级12例，C级10例。22例均冇重度食管静脉曲张，英中16例以呕血、黑便入
2、院，6例以大量腹水入院。结果16例采用内镜下硬化剂注射急诊止血13例成功，3例仍有活动性出血，遂行急诊TIPSo在出血停止后1〜2周择期行口体骨髓间充质干细胞移植。另6例以大屋腹水入院患者待腹水减少后再行干细胞移植。干细胞移植术后2〜4周后择期行TIPS治疗。经随访观察，干细胞移植能明显改善肝功能状态，特别是口蛋口水平升高(P<0.05),PT缩短(PV0.05),腹水减少(PV0.05)«TIPS治疗后8例食管肖静脉曲张消失，14例明显减轻，随访半年内未再出血。结论采用内镜治疗、联合干细胞移植及TIP
3、S的序贯方案，对肝硬化失代偿期患者严重并发症治疗冇重要价值。［关键词］失代偿期肝硕化；口体骨髓干细胞移植；TIPS；内镜下硬化剂注射治疗［中图法分类号］R730.53;R730.57;R737.14［文献标志码］ASequentialregimencombiningtransplantationofbonemarrowstemcells,TIPS,andendoscopicsclerotherapyforendstageliverdiseaseWangJun,FanLilin,LanChunhui,Ya
4、ngJun,YanQixian,XiaoXiao,LiLi,HuLu,LiYa,YangMin,ZhaoRong,CuiHongli,PengAnguo,LiQing,HeYan,ZhouShiliang,WangBin,ChenDongfeng(DepartmentofGastrocntcrology,InstituteofSurgeryResearch,DapingHospital,ThirdMilitaryMedicalUniversity,Chongqing400042,China.)［Abst
5、ract］ObjectiveToinvestigatesequentialtherapyforpatientswithdecompensatedlivercirrhosischaracteristicofabnormalliverfunctionandportalhypertension.MethodsTwenty-twopatientswithdecompensatedlivercirrhosisandserousesophagealvarices,including12withChild-Pughg
6、radeBand10withgradeCwererecruitedbetweenJune2009andAugust2011.Amongthem,sixteencaseswerehospitalizedforhaematemesisormelenaandremainingsixfortenseascites・ResultsSclerotherapywassuccessfulin13outof16caseswithbleedingesophagealvarices.Remaining3wastreatedw
7、ithemergentTIPS.Thenallof16casesweretransplantedwithautologousbonemarrowmesenchymalstemcells(bMSCs)within1-2weeks・The6caseswithtenseascitesweretransplantedwithbMSCsuntilthevolumeofascitesreduced・Withinthenext2-4weeks,all6patientsweretreatedwithTIPS・Follo
8、wupdatashowedthatbMSCstransplantationimprovedliverfunction,especiallyelevatedalbumin(P<0.05),shortenedPT(P<0・05),andreducedascites(P<0.05).AfterTIPStherapy,esophagealvaricesdisappearedin8casesanddiminishedin14cases,without
