门静脉压力梯度预测TIPS术后高危人群肝性脑病的研究

Study of portal venous pressure gradient to predict high-hepatic encephalopathy-risk population post TIPS

经颈静脉肝内门-体分流术(TIPS)能有效地降低门静脉压力以及缓解门静脉高压相关的临床并发症。但是肝性脑病(HE)仍是TIPS术后主要并发症。有研究表明年龄>65岁、肝功能Child-Pugh C级患者是发生TIPS术后HE的高危人群,且早期TIPS治疗能使这部分高危患者生存获益。对60例年龄>65岁和肝功能Child-Pugh C级失代偿期肝硬化合并食管胃底静脉曲张破裂出血患者行TIPS治疗,观察1年的临床结果,评价门静脉压力梯度(PSG)与HE发生率的关系,再将无HE患者的PSG与有HE患者的PSG进行对比分析,评价PSG对HE发生率的影响。

Transjugular intrahepatic portosystemic shunt(TIPS)can effectively reduce the portal venous pressure and relieve the clinical complications related to portal hypertension.However,hepatic encephalopathy(HE)is still the main complication post TIPS.Studies have shown that patients over 65 years old with liver function reserve in Child-Pugh grade C are the high-HE-risk group post TIPS,and early TIPS treatment can benefit the survival of these high-risk patients.In this study,TIPS was used to treat 60 cases aged>65 years old and liver function reserve in Child-Pugh grade C(decompensated liver cirrhosis)with esophagogastric variceal bleeding.The clinical results of 1-year was observed and the porto systemic gradient(PSG)was evaluated.The relationship between the incidence of HE and the PSG of patients with and without HE were compared to evaluate the effect of PSG on the incidence of HE.