经颈静脉肝内门体静脉分流术后肝性脑病的治疗

Transjugular intrahepatic portosystemic shunt and hepatic encephalopathy

经颈静脉肝内门体静脉分流术(TIPS)是近年来用于治疗门静脉高压症伴上消化道出血或顽固性腹水的重要方法,成功率较高,术后有一定的肝性脑病发生率。由于TIPS形成门体分流,造成血流动力学紊乱。肝性脑病预后差,始终作为TIPS的重要并发症之一。与TIPS后肝性脑病的相关因素较多,文献对不同因素的意义有争论。以下就TIPS与肝性脑病之间的关系作一综述。

Transjugular intrahepatic portosystemic shunt （TIPS） has been developed for two decades in order to treat portal hypertension accompanying with upper gastrointestinal hemorrhage and refractory ascites. TIPS may cause the development of hepatic encephalopathy （HE）. TIPS induces portalsystemic shunt and leads to hemodynamics chaos. Hepatic encephalopathy belongs to the complications of the portal hypertension. There are many possible predictors of the post-TIPS HE. The relationship between TIPS and HE was reviewed.