[1]黄乾鑫,张庆桥,徐 浩,等.经颈静脉肝内门体分流术治疗土三七致肝窦阻塞综合征的中远期疗效评价[J].介入放射学杂志,2023,32(07):672-676.
HAUANG Qianxin,ZHANG Qingqiao,XU Hao,et al.Transjugular intrahepatic portosystemic shunt for hepatic sinusoidal obstruction syndrome caused by gynura segetum: evaluation of its mid- long term efficacy[J].journal interventional radiology,2023,32(07):672-676.
点击复制
经颈静脉肝内门体分流术治疗土三七致肝窦阻塞综合征的中远期疗效评价(
)
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
-
32
- 期数:
-
2023年07
- 页码:
-
672-676
- 栏目:
-
临床研究
- 出版日期:
-
2023-07-31
文章信息/Info
- Title:
-
Transjugular intrahepatic portosystemic shunt for hepatic sinusoidal obstruction syndrome caused by gynura segetum: evaluation of its mid- long term efficacy
- 作者:
-
黄乾鑫; 张庆桥; 徐 浩; 魏 宁; 崔艳峰; 刘洪涛; 肖晋昌; 王文亮; 高志康; 神 斌; 顾玉明; 祖茂衡
-
- Author(s):
-
HAUANG Qianxin; ZHANG Qingqiao; XU Hao; WEI Ning; CUI Yanfeng; LIU Hongtao; XIAO Jinchang; WANG Wenliang; GAO Zhikang; SHEN Bin; GU Yuming; ZU Maoheng.
-
Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province 221006, China
-
- 关键词:
-
【关键词】 肝窦阻塞综合征; 土三七; 经颈静脉肝内门体分流术; 存活率
- 文献标志码:
-
A
- 摘要:
-
【摘要】 目的 评价经颈静脉肝内门体分流术(TIPS)治疗土三七致肝窦阻塞综合征(HSOS)的中远期疗效。方法 回顾性分析采用TIPS治疗的22例土三七致HSOS患者临床资料,其中轻度2例,中度4例,重度13例,极重度3例。记录患者手术成功率、术后症状改善情况及随访资料,通过多普勒超声及CTA评估TIPS分流道的通畅状态。运用Kaplan- Meier曲线评估TIPS分流道通畅率。结果 22例患者TIPS技术成功率为100%,术后临床症状均有改善。全部患者随访6~60个月,平均(32.3±18.3)个月。术后1个月患者肝功能Child- Pugh评分由术前(9.1±1.3)分降至术后(7.0±1.0)分,差异有统计学意义(t=5.738, P<0.05)。2例轻度、4例中度及8例重度患者症状于术后3个月完全消失,5例重度及1例极重度患者症状于术后6个月完全消失,2例极重度患者症状于术后1年完全消失。TIPS分流道1、3、5年首次通畅率分别为100%、93.3%、74.7%。随访期间全部患者均存活,均无症状进展或复发。结论 TIPS治疗土三七致HSOS可获得较好的中远期疗效。
参考文献/References:
[1] 刘 璐,张 玮, 诸葛宇征.肝窦阻塞综合征诊断标准综述[J]. 中华肝脏病杂志, 2020, 28:1064- 1068.
[2] 贾翠宇,赵大伟,冯骥良,等. 肝窦阻塞综合征的临床和影像学表现[J]. 临床放射学杂志, 2022, 41:284- 288.
[3] 郭婷婷,李春高,曹玉坤,等. 磁共振动态增强评估吡咯烷生物碱致肝窦阻塞综合征不同临床分期的影像学特征[J]. 临床放射学杂志, 2020, 39:2008- 2012.
[4] Yang XQ,Ye J,Li X,et al.Pyrrolizidine alkaloids- induced hepatic sinusoidal obstruction syndrome: pathogenesis, clinical manifes-tations,diagnosis,treatment,and outcomes[J]. World J Gastroenterol, 2019, 25:3753- 3763.
[5] Peng C,Zhang X,Zhang F,et al.Clinical efficacy and safety of anticoagulation therapy for pyrrolizidine alkaloids- induced hepatic sinusoidal obstruction syndrome: a retrospective multicenter cohort study[J]. Eur J Gastroenterol Hepatol,2020,32:1168- 1178.
[6] Zhang L,Li Q,Makamure J,et al.Transjugular intrahepatic porto-systemic shunt for hepatic sinusoidal obstruction syndrome associated with consumption of gynura segetum[J]. BMC Gastro-enterol,2021,21:26.
[7] Zhou CZ,Wang RF,Lv WF,et al.Transjugular intrahepatic porto-systemic shunt for pyrrolizidine alkaloid- related hepatic sinusoidal obstruction syndrome[J]. World J Gastroenterol, 2020, 26:3472- 3483.
[8] 宋 威,张庆桥,徐 浩,等. 经颈静脉肝内门体分流术治疗土三七致肝窦阻塞综合征的疗效[J]. 中华肝胆外科杂志, 2019,25:418- 421.
[9] 中华医学会消化病学分会肝胆疾病协作组.吡咯生物碱相关肝窦阻塞综合征诊断和治疗专家共识意见(2017年,南京)[J].中华消化内镜杂志, 2017, 34:533- 542.
[10] Mohty M,Malard F,Abecassis M,et al.Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno- occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow Transplantation[J]. Bone Marrow Transplant, 2016, 51:906- 912.
[11] Wang Y,Qiao D,Li Y,et al.Risk factors for hepatic veno- occlusive disease caused by gynura segetum:a retrospective study[J]. BMC Gastroenterol, 2018,18:156.
[12] 李欣澄,赵红川. 肝移植治疗土三七致肝窦阻塞综合征一例[J]. 肝胆外科杂志, 2021, 29:115- 117.
[13] 胡 朋,陈斯良,罗泽龙,等.采用裸支架联合覆膜支架建立经颈静脉肝内门体分流术的中远期疗效[J]. 中国介入影像与治疗学, 2016, 13:394- 397.
[14] 刘 芳,赵剑波,王江云,等. 采用专用覆膜支架行经颈静脉肝内门体分流术2年随访观察[J]. 介入放射学杂志, 2021, 30:888- 892.
[15] Wang P,Qi X,Xu K.Evolution, progress, and prospects of research on transjugular intrahepatic portosystemic shunt applications[J].J Interv Med,2021,4:57- 61.
[16] 侯昌龙,许 军,秦汉林,等. 经颈静脉肝内门体分流术治疗21例土三七相关肝窦阻塞综合征的疗效分析[J]. 中华消化杂志, 2019, 39:251- 256.
[17] Yoon JH,Yoo KH,Sung KW,et al.Validation of treatment outcomes according to revised severity criteria from European Society for Blood and Marrow Transplantation(EBMT) for sinusoidal obstruction syndrome/veno- occlusive disease(SOS/VOD)[J]. Bone Marrow Transplant, 2019, 54:1361- 1368.
[18] 中国医师协会介入医师分会. 中国门静脉高压经颈静脉肝内门体分流术临床实践指南[J].中华肝脏病杂志, 2019, 27:582- 593.
备注/Memo
- 备注/Memo:
-
(收稿日期:2022- 05- 17)
(本文编辑:茹 实)
更新日期/Last Update:
2023-07-31