经颈静脉肝内门体分流术对肝脏及心脏的影响

黄山; 周昊; 陈雪玲; 姚欣; 汤善宏; 杨国栋; 秦建平

doi:10.3969/j.issn.1001-5256.2020.04.043

经颈静脉肝内门体分流术对肝脏及心脏的影响

DOI: 10.3969/j.issn.1001-5256.2020.04.043

1. 川北医学院临床医学院
2. 中国人民解放军西部战区总医院消化内科
3. 川北医学院附属医院消化内科

详细信息

中图分类号: R657.31
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出版历程
- 出版日期: 2020-04-20

Effect of transjugular intrahepatic portosystemic shunt on the liver and the heart

School of Clinical Medicine, North Sichuan Medical College

摘要

摘要: 经颈静脉肝内门体分流术(TIPS)是治疗肝硬化门静脉高压并发症的微创治疗技术。随着TIPS技术的逐渐成熟,支架材料的不断改进,TIPS的适应证不断扩展,并发症发生率逐渐降低,疗效越来越好。一直以来,TIPS术后对患者主要脏器的影响备受关注,就TIPS术对患者肝脏和心脏的影响作一综述。
- 门体分流术,经颈静脉肝内 /
- 高血压,门静脉 /
- 肝 /
- 心脏
Abstract: Transjugular intrahepatic portosystemic shunt( TIPS) is a minimally invasive technique for the treatment of portal hypertension in liver cirrhosis. With the gradual maturity of TIPS technique and the continuous improvement of stent materials,the indications for TIPS are gradually expanded,the incidence rate of complications gradually decreases,and the treatment outcome is getting better and better. The impact of TIPS on the main organs of patients has attracted more and more attention in recent years,and this article reviews the effect of TIPS on the liver and the heart.
- portasystemic shunt,transjugular intrahepatic /
- hypertension,portal /
- liver /
- heart

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参考文献(29)

[1] ROSSLE M,RICHTER GM,NOLDGE G,et al. New non-operative treatment for variceal haemorrhage[J]. Lancet,1989,2(8655):153.

[2] LIU MH,ZHOU F,WANG XB,et al. Follow-up study of 116cases of transjuguhr in trahepafic portosystemic shunt in the treatment of cirrhotic portal hypertension[J]. Chin J Hepatol,2018,26(8):596-600.(in Chinese)刘满华，周峰，王晓兵，等．116例经颈静脉肝内门体静脉分流术治疗肝硬化门静脉高压症的随访研究[J]．中华肝脏病杂志，2018,26(8):596-600.

[3] BUSK TM,BENDTSEN Fl,POULSEN JH,et al. Transjugular intrahepatic portosystemic shunt:Impact on systemic hemodynamics and renal and cardiac function in patients with cirrhosis[J]. Am J Physiol Gastrointest Liver Physiol,2018,314(2):g275-g286.

[4] HUAN H,TONG H,WEI B,et al. Effects of transjugular intrahepatic portosystemic shunt combined with left gastric vein embolization on the liver function of patients with liver cirrhosis[J]. Chin J Dig,2017,37(6):404-410.(in Chinese)宦徽，童欢，魏波，等．经颈静脉肝内门体静脉分流术联合胃左静脉栓塞术对肝硬化患者肝功能的影响[J]．中华消化杂志，2017,37(6):404-410.

[5] TENG D,ZUO H,LIU L,et al. Long-term clinical outcomes in patients with viral hepatitis related liver cirrhosis after transjugular intrahepatic portosystemic shunt treatment[J]. Virol J,2018,15(1):151.

[6] MIAO HF,CHEN Y,ZHAO JB,et al. Changes of liver function after transjugular intarahepatic portosystemic shunt[J]. Chin J Interv Imaging Ther,2016,13(5):267-271.(in Chinese)缪洪飞，陈勇，赵剑波，等．经颈静脉肝内门-体分流术后5年肝功能变化[J]．中国介入影像与治疗学，2016,13(5):267-271.

[7] PALIKHE M,XUE H,JHA PK,et al. Changes in portal hemodynamics after TIPS in liver cirrhosis and portal hypertension[J]. Scand J Gastroenterol,2013,48(5):570-576.

[8] FANG YP,DUAN QH,CHEN X,et al. Clinic value of combined with real-time tissue elastography in monitoring therapeutic effect after transjugular intrahepatic portal-systemic stenting shunt[J]. J Clin Ultrasound in Med,2015,17(6):386-388.(in Chinese)方彦鹏，段庆红，陈霞，等．CDFI与实时组织弹性成像联合监测在肝硬化经颈静脉肝内门体分流术术后疗效的临床价值[J]．临床超声医学杂志，2015,17(6):386-388.

[9] WANG YH,WANG YZ. Application of color Doppler ultrasound in fol ow-up after transjugular intrahepatic portosystemic shunt combined with esophagogastric variceal embolization[J]. Chin J Clin Res,2017,30(9):1225-1227.(in Chinese)王艳华，王涌臻．彩色多普勒超声在经颈静脉肝内门体分流术联合食管胃底曲张静脉栓塞术后随访中的应用[J]．中国临床研究，2017,30(9):1225-1227.

[10] STANKOVIC Z,ROSSLE M,EURINGER W,et al. Effect of TIPS placement on portal and splanchnic arterial blood flow in 4-dimensional flow MRI[J]. Eur Radiol,2015,25(9):2634-2640.

[11] BANNAS P,ROLDAN-ALZATE A,JOHNSON KM,et al. Longitudinal monitoring of hepatic blood flow before and after TIPS by using 4D-flow MR imaging[J]. Radiology,2016,281(2):574-582.

[12] WU JJ,LI YC,SUN Y,et al. Changes and clinical value of hepatic perfusion parameters after TIPS[J]. J China Clin Med Imag,2015,26(3):217-219．吴晶晶，李迎春，孙勇，等．TIPS术后肝脏灌注指标的变化及临床意义[J]．中国临床医学影像杂志，2015,26(3):217-219.

[13] ZHAO YL,LIU SS,YAO DJ,et al. Clinical study of transjuglar intrahepatic portosystemic shunt for cirrhosis with portal hypertension[J]. China Med Herald,2018,15(28):81-84.(in Chinese)赵玉龙，刘顺顺，姚德炯，等．经颈静脉肝内门体分流术治疗肝硬化门静脉高压症的临床研究[J]．中国医药导报，2018,15(28):81-84.

[14] PREIBSCH H,SPIRA D,THAISS WM,et al. Impact of transjugular intrahepatic portosystemic shunt implantation on liver perfusion measured by volume perfusion CT[J]. Acta Radiol,2017,58(10):1167-1173.

[15] BUSK TM,BENDTSEN F,HENRIKSEN JH,et al. Effects of transjugular intrahepatic portosystemic shunt(TIPS)on blood volume distribution in patients with cirrhosis[J]. Dig Liver Dis,2017,49(12):1353-1359.

[16] JANSEN C,MOLLER P,MEYER C,et al. Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality[J]. Hepatology,2018,67(4):1472-1484.

[17] PIECHA F,PAECH D,SOLLORS J,et al. Rapid change of liver stiffness after variceal ligation and TIPS implantation[J]. Am J Physiol Gastrointest Liver Physiol,2018,314(2):g179-g187.

[18] HAN H,YANG J,GONG L,et al. Application value of conventional ultrasonography combined with shear wave elastography in transjugular intrahepatic portosystemic shunt[J/CD]. Chin J Med Ultrasound(Electronic edition),2016,13(12):904-906．韩浩，杨建，龚黎，等．常规超声检查联合剪切波弹性成像技术在经颈静脉肝内门体静脉分流术中的应用价值[J/CD]．中华医学超声杂志(电子版)，2016,13(12):904-906.

[19] de SANTIS A,NARDELLI S,BASSANELLI C,et al. Modification of splenic stiffness on acoustic radiation force impulse parallels the variation of portal pressure induced by transjugular intrahepatic portosystemic shunt[J]. J Gastroenterol Hepatol,2018,33(3):704-709.

[20] HAN H,YANG J,ZHUGE YZ,et al. Point shear wave elastography to evaluate and monitor changing portal venous pressure in patients with decompensated cirrhosis[J]. Ultrasound Med Biol,2017,43(6):1134-1140.

[21] HAN H,YANG J,ZHUGE YZ,et al. Diagnostic value of color Doppler ultrasonography in detecting transjugular intrahepatic porrosystemic shunt dysfunction[J]. J Clin Ultrasound in Med,2015,17(8):522-525.(in Chinese)韩浩，杨建，诸葛宇征，等．彩色多普勒超声对经颈静脉肝内门体分流术后支架功能障碍的诊断价值[J]．临床超声医学杂志，2015,17(8):522-525.

[22] YANG J,WU M,ZHUGE YZ,et al. Ultrasound evaluation of restrictive transjugular intrahepatic porrosystemic shunt combined with selective esophageal and gastric barceal embolization[J]. J Clin Ultrasound in Med,2014,16(5):297-299.(in Chinese)杨建，吴敏，诸葛宇征，等．彩色多普勒超声在限制性经颈静脉肝内门体分流术联合食管胃底曲张静脉组织胶栓塞术中的应用[J]．临床超声医学杂志，2014,16(5):297-299.

[23] VASATOVA M,PUDIL R,SAFKA V,et al. Elevated cardiac markers are associated with higher mortality in patients after transjugular intrahepatic portosystemic shunt insertion[J].Ann Clin Biochem,2013,50(2):122-126.

[24] FILI D,FALLETTA C,LUCA A,et al. Circulatory response to volume expansion and transjugular intrahepatic portosystemic shunt in refractory ascites:Relationship with diastolic dysfunction[J]. Dig Liver Dis,2015,47(12):1052-1058.

[25] MODHA K,KAPOOR B,LOPEZ R,et al. Symptomatic heart failure after transjugular intrahepatic portosystemic shunt placement:incidence,outcomes,and predictors[J]. Cardiovasc Intervent Radiol,2018,41(4):564-571.

[26] TREBICKA J. Does transjugular intrahepatic portosystemic shunt stent differentially improve survival in a subset of cirrhotic patients?[J]. Semin Liver Dis,2018,38(1):87-96.

[27] KOVACS A,SCHEPKE M,HELLER J,et al. Short-term effects of transjugular intrahepatic shunt on cardiac function assessed by cardiac MRI:preliminary results[J]. Cardiovasc Intervent Radiol,2010,33(2):290-296.

[28] MERLI M,VALERIANO V,FUNARO S,et al. Modifications of cardiac function in cirrhotic patients treated with transjugular intrahepatic portosystemic shunt(TIPS)[J]. Am J Gastroenterol,2002,97(1):142-148.

[29] WANNHOFF A,HIPPCHEN T,WEISS CS,et al. Cardiac volume overload and pulmonary hypertension in long-term fol ow-up of patients with a transjugular intrahepatic portosystemic shunt[J].Aliment Pharmacol Ther,2016,43(9):955-965.

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