【摘要】 目的探讨经颈静脉肝内门体分流术治疗肝硬化门静脉高压症的效果。方法选择新疆兵团第一师医院2015年1月~2016年12月收治的肝硬化门静脉高压症患者54例,按照随机数字表法将其分为观察组和对照组,每组各27例。观察组采用经颈静脉肝内门体分流术治疗,对照组采用贲门周围血管离断术治疗。对比两组患者的手术效果、手术前后的血流动力学指标、肝功能指标,观察术后不良事件发生情况。结果两组临床总有效率比较差异无统计学意义(P>0.05)。观察组术后门静脉直径、门静脉血流量、脾静脉内径、脾静脉血流量均低于对照组,而门静脉流速、脾静脉流速则高于对照组,差异均有统计学意义(P<0.05)。观察组术后谷丙转氨酶、谷草转氨酶、总胆红素水平均低于对照组(P<0.05)。观察组不良事件发生率显著低于对照组(P<0.05)。结论经颈静脉肝内门体分流术治疗肝硬化门静脉高压症效果显著,可显著改善患者血流动力学指标及肝功能,降低术后不良事件发生率。更多还原

【Abstract】 Objective To investigate the efficacy of transjugular intrahepatic portosystemic shunt for cirrhosis with portal hypertension.Methods Fifty-four cases of cirrhosis patients with portal hypertension admitted to the First Division Hospital of Xinjiang Production and Construction Corps from January 2015 to December 2016 were selected.According to random number table method,they were divided into observation group and control group,with 27 cases in each group.The observation group was treated by transjugular intrahepatic portosystemic shunt,and the control group was treated by pericardial devascularization.The operation effect,hemodynamic indexes and liver function indexes before and after operation of two groups were compared,and the incidence of adverse events after operation was observed.Results There was no significant difference in total clinical effective rate between the two groups(P > 0.05).After operation,the diameter of portal vein,portal vein blood flow,splenic vein diameter and splenic vein blood flow in observation group were lower than those of control group,while the portal venous flow velocity and the splenic vein velocity were higher than those of control group,the differences were statistically significant(P < 0.05).After operation,the levels of alanine transaminase,aspartate aminotransferase and total bilirubin in observation group were lower than those of control group(P < 0.05).The incidence of adverse events in observation group was significantly lower than that in control group(P < 0.05).Conclusion Transjugular intrahepatic portosystemic shunt is effective in the treatment of cirrhosis with portal hypertension.It can significantly improve the hemodynamic indexes and liver function,and reduce the incidence of postoperative adverse events.更多还原