A case of spontaneous portosystemic shunt with hepatic encephalopathy
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摘要:
<正>肝硬化门静脉高压时,可形成侧支循环,称门-腔循环或门-体循环。其通路有胃静脉-食管静脉、肠系膜下静脉-髂内静脉、副脐静脉-腹腔静脉、脾-肾、胃-肾吻合支等,肝内型门静脉右后支与下腔静脉的自发性门体分流(spontaneous portosystemic shunt,SPSS)较少见,现将近期收治的1例肝SPSS报道如下。1病例资料患者男性,44岁,因"间断黑便8年,反复神志不清3年,加重1 d"于2018年1月入本院。8年前患者因黑便入重庆医
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Key words:
- hypertension, portal /
- hepatic encephalopathy /
- case reports
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[1] TANG SH, ZENG WZ, WU XL, et al. Formation of collateralcirculation in patients with cirrhotic portal hypertension and itsclinical significance[J]. J Clin Hepatol, 2016, 32 (8) :1613-1616. (in Chinese) 汤善宏, 曾维政, 吴晓玲, 等.肝硬化门静脉高压侧支循环的形成及其临床意义[J].临床肝胆病杂志, 2016, 32 (8) :1613-1616. [2] WU WB, HAN GH. Embolization of spontaneous portosystemicshunt for cirrhotic patients with portal hypertension:A review ofcurrent status[J]. J Clin Hepatol, 2015, 31 (9) :1528-1531. (in Chinese) 武文彬, 韩国宏.肝硬化门静脉高压伴自发性门体分流患者的诊治现状[J].临床肝胆病杂志, 2015, 31 (9) :1528-1531. [3] SENOCAK E, O GˇUZ B, EDGER T, et al. Congenital intrahe-patic portosystemic shunt with variant inferior right hepatic vein[J]. Diagn Interv Radiol, 2008, 14 (2) :97-99. [4] WANG HM, LIU XB, WANG RJ, et al. Spontaneous extrahe-patic portocaval shunt:Case report[J]. Chin J Med ImagingTechnol, 2004, 20 (10) :1486. (in Chinese) 王华明, 刘晓波, 王如锦, 等.自发性肝外型门静脉一下腔静脉分流1例[J].中国医学影像技术, 2004, 20 (10) :1486. [5] TSAUO J, LIU L, TANG C, et al. Education and Imaging.Hepatobiliary and pancreatic:Spontaneous intrahepatic porto-systemic shunt associated with cirrhosis[J]. J GastroenterolHepatol, 2013, 28:904. [6] QI X, YE C, HOU Y, et al. A large spontaneous intrahepaticportosystemic shunt in a cirrhotic patient[J]. J IntractableRare Dis Res, 2016, 5 (1) :58-60. [7] ZHOU W. The advances in the pathogenesis of hepatic en-cephalopathy after transjugular intrahepatic portosystemicshunt[J]. Med Pharm Yunnan, 2014, 35 (1) :73-75. (inChinese) 周薇.经颈静脉肝内门体分流术术后肝性脑病发病机制的研究进展[J].云南医药, 2014, 35 (1) :73-75. [8] ZHANG ZM, FENG HQ, LENG XS, et al. The Changes ofPRA、ACE and AⅡlevels in plasma of cirrhotic patients withascites after portocaval shunt[J]. J Med Beijing Milit Region, 1998, 10 (5) :321-323. (in Chinese) 张忠明, 冯洪强, 冷希圣, 等.肝硬化腹水病人门腔静脉分流前后肾素活性血管紧张素转化酶和血管紧张素Ⅱ水平的变化[J].北京军区医药, 1998, 10 (5) :321-323. [9] CHEUNG J, SOO I, BASTIAMPILLAI R, et al. Urgent vs. non-urgent endoscopy in stable acute variceal bleeding[J]. AmJ Gastroenterol, 2009, 1 (104) :1125-1129. [10] HSU YC, CHEN CC, WANG HP. Endoscopy timing in acutevariceal hemorrhage:Perhaps not the sooner the better, butdelay not justified[J]. Am J Gastroenterol, 2009, 1 (104) :2629-2630. [11] BOYER TD, HASKAL ZJ. The role of transjugular intrahepaticportosystemic shunt (TIPS) in the management of portal hy-pertension:Update 2009[J]. Hepatology, 2010, 51 (1) :306. [12] AN J, KIM KW, HAN S, et al. Improvement in survival associ-ated with embolisation of spontaneous portosystemic shunt inpatients with recurrent hepatic encephalopathy[J]. AlimentPharmacol Ther, 2014, 39 (12) :1418-1426. [13] LALEMAN W, SIMON-TALERO M, MALEUX G, et al. Embo-lization of large spontaneous portosystemic shunts for refracto-ry hepatic encephalopathy:A multicenter survey on safety andefficacy[J]. Hepatology, 2013, 57 (6) :2448-2457. [14] WU W, HE C, HAN G. Embolization of spontaneous splenore-nal shunt for after-TIPS hepatic encephalopathy in a patientwith cirrhosis and variceal bleeding[J]. Hepatology, 2015, 61 (5) :1761-1762.
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