经颈静脉肝内门体分流术在肝硬化静脉曲张出血防治中的地位

Role of transjugular intrahepatic portosystemic shunt in prevention and treatment of variceal bleeding in liver cirrhosis

静脉曲张出血是肝硬化门静脉高压常见的致死性并发症,大约50%的肝硬化患者在诊断为肝硬化时既已合并静脉曲张。自从1988年经颈静脉肝内门体分流术(TIPS)首次应用于临床以来,大量的临床研究不断的更新与完善了TIPS的相关知识。本文主要对TIPS在肝硬化门静脉高压静脉曲张出血的防治中的地位作一综述,包括TIPS在肝硬化门脉高压静脉曲张出血的初级预防、急性静脉曲张出血的治疗以及肝硬化静脉曲张再出血的预防中的应用。TIPS是肝硬化门静脉高压静脉曲张的有效疗法,随着技术的不断进步,将有越来越多的患者成为TIPS的适应证,TIPS在肝硬化门脉高压静脉曲张出血的防治中将发挥越来越重要的作用。

In patients with liver cirrhosis, variceal bleeding is a common fatal complication of portal hypertension. Varices are present in almost half of patients with cirrhosis at the time of diagnosis. Since transjugular intrahepatic portosystemic shunt （TIPS） was first applied clinically in 1988, the relevant information about TIPS has been continually updated and perfected by lots of clinical trials. The role of TIPS in the prevention and treatment of variceal bleeding in cirrhotic patients with portal hypertension, including primary prevention of variceal bleeding, treatment of acute variceal bleeding, and prevention of rebleeding, is reviewed. TIPS is an effective treatment for variceal bleeding in cirrhotic patients with portal hypertension. Along with the technical development, TIPS will be available for more and more patients and will play an increasingly important role in the prevention and treatment of varieeal bleeding among cirrhotic patients with portal hypertension.