经颈静脉肝内门体分流术治疗肝硬化顽固性腹水的现状

TIPS for treatment of refractory ascites in cirrhosis

顽固性腹水是肝硬化失代偿期门静脉高压的并发症之一,其治疗难度大,病死率高。目前经颈静脉肝内门体分流术(TIPS)作为顽固性腹水的二线治疗,能通过降低门静脉压力来改善腹水症状。国内外大量研究已经提出,使用覆膜TIPS支架,谨慎选择适用人群可以改善顽固性腹水患者的预后,因此有学者提出TIPS可作为顽固性腹水的一线治疗手段。本文将全面介绍国内外TIPS治疗肝硬化顽固性腹水的现状,并对相关研究进展进行阐述,旨在推动我国TIPS治疗顽固性腹水相关研究的发展。

Refractory ascites(RA)is one of the complications of portal hypertension in decompensated cirrhosis.It is hard to treat RA and there is high mortality in patients with RA.Nowadays,Transjugular Intrahepatic Portosystemic Shunt(TIPS)is used as a second-line treatment for RA.TIPS can improve the clinical symptoms of ascites by reducing the pressure of portal vein.Accumulated studies have proposed that applications of polytetrafluoroethylene covered stents and careful selection of applied patients can improve the prognosis of RA patients.Therefore,some scholars propose that TIPS can be used as one of the first-line treatments for RA.This review will comprehensively summarize current understanding of TIPS in treating RA patients and elaborate the most recently updated progress of the relevant researches,aiming to promote the development of studies on using TIPS as a treatment for RA patients in China.