经颈静脉肝内门体分流术后肝性脑病的研究现状

陈功海; 王广川; 张春清

doi:10.3969/j.issn.1001-5256.2021.05.047

经颈静脉肝内门体分流术后肝性脑病的研究现状

DOI: 10.3969/j.issn.1001-5256.2021.05.047

陈功海¹,
王广川²,
张春清^{1, 2, ,}

1.
山东大学附属省立医院消化内科，济南 250021
2.
山东第一医科大学附属省立医院消化内科，济南 250021

基金项目:

济南市临床医学科技创新计划项目 (201805069);

国家自然科学基金项目 (81770606)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明： 陈功海负责查阅国内外文献并撰写论文；王广川负责论文的审校；张春清负责指导论文撰写、审校并最后定稿。

详细信息

作者简介:
陈功海(1994—)，男，主要从事门静脉高压症及其并发症的防治研究

通信作者:
张春清，13583188661@163.com

中图分类号: R575
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- 被引次数: 0
出版历程
- 收稿日期: 2020-10-30
- 录用日期: 2020-12-15
- 出版日期: 2021-05-20

Current status of research on hepatic encephalopathy after transjugular intrahepatic portosystemic shunt

1.
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
2.
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China

摘要

摘要: 肝性脑病是经颈静脉肝内门体分流术(TIPS)后常见的并发症，目前尚无系统的防治策略。在近些年国内外相关研究的基础上，重点分析并总结了TIPS术后肝性脑病的危险因素及防治进展, 提出未来研究应注重隐性肝性脑病的早期诊断和预防，规范TIPS术后肝性脑病的预防策略。
- 门体分流术，经颈静脉肝内 /
- 肝性脑病 /
- 危险因素 /
- 治疗学 /
- 预防
Abstract: Hepatic encephalopathy (HE) is a common complication after transjugular intrahepatic portosystemic shunt (TIPS), and there are still no systematic strategies for prevention and treatment at present. Based on recent studies in China and foreign countries, this article analyzes and summarizes the risk factors for HE after TIPS and the advances in treatment and prevention. It is pointed out that early diagnosis and prevention of covert HE should be emphasized in further research, and it is important to standardize the prevention strategies for HE after TIPS.
- Portasystemic Shunt, Transjugular Intrahepatic /
- Hepatic Encephalopathy /
- Risk Factors /
- Therapeutics /
- Prevention

HTML全文

表 1 有关TIPS术后HE危险因素的研究总结

作者	时间(年)	独立危险因素
Li Y等^[3]	2019	年龄、Child-Pugh评分、纤维蛋白原
Nardelli S等^[8]	2016	既往HE病史、年龄、低门体静脉压力梯度、高Child-Pugh评分、血肌酐升高及低血钠
Zivony AS等^[15]	2014	PSG下降≥60%
Bai M等^[16]	2011	年龄＞65岁、HE病史以及Child-Pugh评分＞10
Yin X等^[17]	2019	糖尿病、年龄
Nardelli S等^[18]	2017	MELD评分、肌少症
Rowley MW等^[19]	2018	支架直径＞8 mm、既往HE病史、血清白蛋白≤ 2.5 g/dl
Fonio P等^[20]	2017	年龄＞60岁
Casadaban LC等^[21]	2015	MELD评分、年龄≥65岁
Routhu M等^[22]	2017	年龄、术前门静脉压力、血肌酐、糖尿病
Lewis DS等^[23]	2019	年龄大、男性、MELD评分高、HE病史、HE预防用药史、PPI治疗(与剂量呈正相关)
Sturm L等^[24]	2018	PPI治疗(与剂量呈正相关)
注：PSG，门体循环压力梯度；PPI，质子泵抑制剂。

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