Effect of TIPS on the treatment of elderly patients with cirrhotic portal hypertension and hemody-namics
10.3969/j.issn.1005-6483.2018.01.015
- VernacularTitle:经颈静脉肝内门体分流术治疗老年肝硬化门静脉高压症的疗效及对血流动力学的影响
- Author:
Lei WANG
1
;
Wenqing WANG
Author Information
1. 泰康仙林鼓楼医院普外科
- Keywords:
transjugular intrahepatic portosystemic shunt;
elderly;
portal hypertension caused by hepatic cirrhosis;
hemodynamics
- From:
Journal of Clinical Surgery
2018;26(1):47-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of transjugular intrahepatic portosystemic shunt(TIPS)on the treatment of elderly patients with liver cirrhosis induced portal hypertension(PHT)and hemodynamics. Methods A total of 158 patients with liver cirrhosis induced PHT enrolled into depart-ment of hepatobiliary surgery in Nanjing Drum Tower hospital from 2013 till now and underwent TIPS were collected into our study. The portal system hemodynamics,surgical treatment,liver function and other labo-ratory indicators were recorded and compared before and after operation. Results At one month after op-eration,the portosystemic pressure gradient 18. 51 ± 3. 09(mmHg),portal vein diameter(PVD)1. 22 ± 0. 51(cm),portal vein flow(PVF)816. 9 ± 214. 8(ml),singular value decomposition(SVD)1. 09 ± 0. 27 (cm),splenic vein flow(SVF)355. 4 ± 18. 39(ml)had decreased compared with those before operation (P < 0. 05). The portal venous flow velocity(PVV)46. 27 ± 20. 65(cm/ s)and splenic vein flow velocity (SVV)25. 26 ± 4. 17(cm/ s)had increased compared with those before operation(P < 0. 05). The liver function [total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate transaminase(AST)]had in-creased compared with those before operation(P < 0. 05). At the sixth month after operation,ATL and AST decreased gradually compared with those before treatment(P < 0. 05). Serum albumin(ALB)had no significant changes before and after operation(P > 0. 05). The plasma levels of plasma renin activity (PRA),angiotensin II(ATII)and endothelin(ET)had significantly decreased after one month post opera-tive,and the difference was statistically significant(P < 0. 05). The clinical efficacy was evaluated in 113 cases(71. 52％)as the effective,40 cases(25. 32％)as the improved and 5 cases(3. 16％)as the ineffec-tive. Conclusion TIPS can be used in the treatment of elderly patients with cirrhosis caused PHT,with the advantages of minimally invasive,reliable operation,while postoperative complications should be paid attention.
