CAJ | 학술논문

目的了解无消化道出血史的肝硬化患者经颈静脉肝内门体静脉分流术(TIPS)术后生存现状.方法对于2004年至2013年间自愿行TIPS的15例无消化道出血史的肝硬化患者进行随访追踪,了解其手术成功率及手术难度、肝性脑病发生率、消化道出血发生率、脾功能亢进改善等情况.结果手术成功率为100％,手术平均时间约60 min.术后随访期间无支架成角畸形者;15例患者TIPS术后均未发生消化道出血;亦无患者死亡.有4例于术后8周内发生肝性脑病;4例患者贫血较术前改善.结论 TIPS对肝硬化合并重度食管胃静脉曲张患者预防消化道出血安全有效,或可成为肝硬化无出血患者的一级预防治疗方案.
목적 료해무소화도출혈사적간경화환자경경정맥간내문체정맥분류술(TIPS)술후생존현상.방법 대우2004년지2013년간자원행TIPS적15례무소화도출혈사적간경화환자진행수방추종,료해기수술성공솔급수술난도、간성뇌병발생솔、소화도출혈발생솔、비공능항진개선등정황.결과 수술성공솔위100％,수술평균시간약60 min.술후수방기간무지가성각기형자;15례환자TIPS술후균미발생소화도출혈;역무환자사망.유4례우술후8주내발생간성뇌병;4례환자빈혈교술전개선.결론 TIPS대간경화합병중도식관위정맥곡장환자예방소화도출혈안전유효,혹가성위간경화무출혈환자적일급예방치료방안.
Objective To investigate the survival status of liver cirrhosis patients without upper gastrointestinal hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS).Methods From 2004 to 2013,15 liver cirrhosis patients without upper gastrointestinal hemorrhage volunteered received TIPS treatment were followed up to find out the difficulty and the success rate of TIPS procedure,the incidence of hepatic encephalopathy,upper gastrointestinal hemorrhage and improving of hypersplenism.Results The success rate of operation was 100％.The average of operation time was 60 minutes.During follow-up,no stent angulation occurred,no gastrointestinal hemorrhage happened and no one died in all 15 patients after TIPS operation.There were four patients with hepatic encephalopathy in eight weeks after operation.The anemia of four patients improved compared with that before operation.Conclusions TIPS is a safe and effective threapy in the prevention of gastrointestinal hemorrhage in the patients with liver cirrhosis accompanied with severe gastroesophageal varices.It may become the primary prophylaxis for liver cirrhosis patients without upper gastrointestinal hemorrhage.