经颈静脉肝内门体分流术后肝性脑病预后因素研究进展

Research progress in studying the prognostic factors of hepatic encephalopathy occurring after transjugular intrahepatic portosystemic shunt

1988年经颈静脉肝内门体分流术(TIPS)首次临床应用以来,TIPS相关理论和技术日益完善。然而术后肝性脑病(HE)发生仍是限制其临床广泛应用的主要并发症。因此,掌握TIPS术后HE发生的预后因素,可有效预防其发生。既往已有许多TIPS术后HE预后因素的报道,包括患者年龄、术前HE发生史、Child-Pugh分级、血氨水平、门静脉压力梯度等。本文主要就TIPS术后HE预后因素最新研究进展及本中心经验作一综述。

Objective Since the first clinical application of transjugular intrahepatic portosystemic shunt(TIPS)in 1988,the theories and techniques related to TIPS have become increasingly perfect.However,post-TIPS hepatic encephalopathy(HE)has been a major complication that limits its widespread use in clinical practice.Therefore,a full understanding of the prognostic factors for post-TIPS HE can effectively prevent its occurrence.There have already been many reports concerning the prognostic factors for post-TIPS HE so far.These reports have analyzed and investigated the risk factors for post-TIPS HE,including patient age,history of preoperative HE,Child-Pugh grade,blood ammonia level,portal vein pressure gradient,etc.This paper aims to provide a detailed review about the latest progress in the research of prognostic factors for post-TIPS HE and to summarize the clinical experience in dealing with post-TIPS HE at authors’medical center.(J Intervent Radiol,2022,31:301-306)