中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2011年
5期
299-302
,共4页
原姗姗%韩国宏%柏明%殷占新%何创业%王建宏%祁兴顺%吴开春%樊代明
原姍姍%韓國宏%柏明%慇佔新%何創業%王建宏%祁興順%吳開春%樊代明
원산산%한국굉%백명%은점신%하창업%왕건굉%기흥순%오개춘%번대명
肝硬化%高血压,门静脉%食管和胃静脉曲张%胃肠出血%预后%门体分流术,经颈静脉肝内
肝硬化%高血壓,門靜脈%食管和胃靜脈麯張%胃腸齣血%預後%門體分流術,經頸靜脈肝內
간경화%고혈압,문정맥%식관화위정맥곡장%위장출혈%예후%문체분류술,경경정맥간내
Liver cirrhosis%Hypertension,portal%Esophageal and gastric varices%Gastrintestinal hemorrhage%Prognosis%Portasystemic shunt,transjngular intrahepatic
目的 分析经颈静脉肝内门体静脉分流(TIPS)术治疗肝硬化静脉曲张出血患者的预后因素.方法 收集2003年1月至2008年12月162例行TIPS术的肝硬化静脉曲张出血患者基本资料、术前7 d内相关生化指标,定期随访观察术后情况和生存期资料.Cox回归模型评估影响预后生存的指标.结果 TIPS术成功率99%(161/162).中位随访时间21个月.Child-Pugh评分和血小板计数与生存密切相关(P值分别=0.003和0.024).Child-Pughr评分<9分者的累积生存率[75%(102/136)]高于评分≥9分者[50%(13/26),χ2=9.12,P=0.003].血小板计数>47×109/L者的累积生存率[74%(82/112)]高于≤47×109/L者[66%(33/50),χ2=4.528,P=0.033].肝功能Child-Pugh A、B、C级术后1年累积生存率分别为92%、85%、55%.结论 Child-Pugh评分和血小板计数是预测TIPS术治疗肝硬化静脉曲张出血者生存情况的独立因素,当ChildPugh评分≥9分和(或)血小板计数≤47×109/L时术后危险性增加.
目的 分析經頸靜脈肝內門體靜脈分流(TIPS)術治療肝硬化靜脈麯張齣血患者的預後因素.方法 收集2003年1月至2008年12月162例行TIPS術的肝硬化靜脈麯張齣血患者基本資料、術前7 d內相關生化指標,定期隨訪觀察術後情況和生存期資料.Cox迴歸模型評估影響預後生存的指標.結果 TIPS術成功率99%(161/162).中位隨訪時間21箇月.Child-Pugh評分和血小闆計數與生存密切相關(P值分彆=0.003和0.024).Child-Pughr評分<9分者的纍積生存率[75%(102/136)]高于評分≥9分者[50%(13/26),χ2=9.12,P=0.003].血小闆計數>47×109/L者的纍積生存率[74%(82/112)]高于≤47×109/L者[66%(33/50),χ2=4.528,P=0.033].肝功能Child-Pugh A、B、C級術後1年纍積生存率分彆為92%、85%、55%.結論 Child-Pugh評分和血小闆計數是預測TIPS術治療肝硬化靜脈麯張齣血者生存情況的獨立因素,噹ChildPugh評分≥9分和(或)血小闆計數≤47×109/L時術後危險性增加.
목적 분석경경정맥간내문체정맥분류(TIPS)술치료간경화정맥곡장출혈환자적예후인소.방법 수집2003년1월지2008년12월162례행TIPS술적간경화정맥곡장출혈환자기본자료、술전7 d내상관생화지표,정기수방관찰술후정황화생존기자료.Cox회귀모형평고영향예후생존적지표.결과 TIPS술성공솔99%(161/162).중위수방시간21개월.Child-Pugh평분화혈소판계수여생존밀절상관(P치분별=0.003화0.024).Child-Pughr평분<9분자적루적생존솔[75%(102/136)]고우평분≥9분자[50%(13/26),χ2=9.12,P=0.003].혈소판계수>47×109/L자적루적생존솔[74%(82/112)]고우≤47×109/L자[66%(33/50),χ2=4.528,P=0.033].간공능Child-Pugh A、B、C급술후1년루적생존솔분별위92%、85%、55%.결론 Child-Pugh평분화혈소판계수시예측TIPS술치료간경화정맥곡장출혈자생존정황적독립인소,당ChildPugh평분≥9분화(혹)혈소판계수≤47×109/L시술후위험성증가.
Objective To analyze the prognostic factors in treating variceal hemorrhage patients of liver cirrhosis and portal hypertension with transjugular intrahepatic portosystemic shunt (TIPS).Methods From January 2003 to December 2008, the data of 162 variceal hemorrhage patients with liver cirrhosis and portal hypertension treated with TIPS was collected, which included basic information, biochemical examination results within 7 days before the operation, regular follow-up observation after the surgery and survival data. The survival prognostic indexes were assessed with Cox regression model. Results The successful rate of TIPS was 99% (161/162). The median follow up duration was 21 months. Child-Pugh score and blood platelet count (PLT) were closely correlated with survival (P = 0. 003 and 0. 024). The total cumulative survival rate in patients with Child-Pugh score below nine (75%, 102/136) was higher than over nine (50%, 13/26) (χ2 = 9. 12,P=0. 003).The total cumulative survival rate of patients with PLT count over 47 ×109/L (74%, 82/112) was higher than below 47 × 109/L(66 %, 33/50, χ2 =4. 528, P = 0. 033). The one year after operation cumulative survival rate of liver function Child-Pugh class A, B, and C was 92%, 85%, 55% respectively. Conclusion Child-Pugh score and platelet count are independent predictable factors for the survival of variceal hemorrhage patients with liver cirrhosis and portal hypertension treated by TIPS. The risk increase after operation when Child-Pugh score over 9 and/or PLT count less 47×109 /L.
