Clinical impact of transjugular intrahepatic portosystemic shunt on refractory hepatic sinus obstruction syndrome caused by Gynura segetum
10.3760/cma.j.cn113884-20220305-00088
- VernacularTitle:TIPS治疗土三七导致难治性肝窦阻塞综合征临床疗效观察
- Author:
Rutao XU
1
;
Kewei ZHANG
;
Mingzhe CUI
;
Weixiao LI
;
Dongbin ZHANG
;
Kai LIANG
;
Xiaoyang FU
;
Junping LIU
;
Zhenhua JIANG
;
Shuiting ZHAI
Author Information
1. 河南省人民医院（郑州大学人民医院）血管外科，郑州 450003
- Keywords:
Portosystemic shunt, transjugular intrahepatic;
Treatment outcome;
Hepatic sinusoidal obstruction syndrome;
Pyrrolizidine alkaloid
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(7):491-494
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the treatment outcomes of transjugular intrahepatic portal shunt (TIPS) on refractory hepatic sinus obstruction syndrome (HSOS) caused by Gynura segetum.Methods:The clinical data of 15 patients with refractory HSOS caused by Gynura segetum treated at the Department of Vascular Surgery, Henan Provincial People's Hospital from January 2017 to April 2021 were retrospectively analyzed. There were 7 males and 8 females, with ages ranging from 30 to 85 years, mean ± s. d. (61.2±14.1) years. Albumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, glutamyl transferase, and portal vein pressure were compared before and after TIPS. The liver function and renal function of these patients were followed up.Results:When compared with pre-operation, the albumin, alanine aminotransferase, aspartate aminotransferase and other indexes were significantly improved after TIPS (all P<0.05). The portal vein pressure of 15 patients significantly decreased from the preoperative volume of (41.7±3.5) cmH 2O (1 cmH 2O=0.098 kPa) to (28.3±4.4) cmH 2O ( t=10.41, P<0.001). The preoperative liver function was Child-Pugh grade A in 1 patient, grade B in 8 patients, grade C in 6 patients. The postoperative Child-Pugh grading was grade A in 14 patients and grade B in 1 patient. Ascites, gastrointestinal bleeding, abdominal pain, abdominal distention and spontaneous peritonitis all disappeared in these 15 patients. Postoperative hepatic encephalopathy developed in 2 patients and hepatic myelopathy in 1 patient. Conclusion:TIPS for treatment of HSOS caused by Gynura segetum resulted in a rapid recovery of liver function, rapid symptomatic relief, with a low incidence of hepatic encephalopathy/hepatic myelopathy.
