Anticoagulant therapy and transjugular intrahepatic portosystemic shunt for pyrrolizidine alkaloid related hepatic sinusoidal obstruction syndrome
10.3969/j.issn.1001-5256.2022.06.005
- VernacularTitle:吡咯里西啶生物碱相关肝窦阻塞综合征的抗凝-经颈静脉肝内门体分流术阶梯治疗
- Author:
Wei ZHANG
1
;
Yuzheng ZHUGE
1
Author Information
1. Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210004, China
- Publication Type:Discussions by Experts
- Keywords:
Hepatic Veno-Occlusive Disease;
Pyrrolizidine Alkaloids;
Anticoagulants;
Portasystemic Shunt, Transjugular Intrahepatic
- From:
Journal of Clinical Hepatology
2022;38(6):1234-1236
- CountryChina
- Language:Chinese
-
Abstract:
Hepatic sinusoidal obstruction syndrome (HSOS) is a vascular liver disease characterized by varying degrees of liver injury and portal hypertension. HSOS in China is mostly associated with the intake of pyrrolizidine alkaloids. The step-up approach with anticoagulant therapy and transjugular intrahepatic portosystemic shunt (TIPS) as the core treatment methods is the therapy currently recommended for this disease. Subcutaneous injection of low-molecular-weight heparin is the first choice for anticoagulant therapy, and oral warfarin can be used in combination or sequentially to enhance anticoagulation. Patients with no response to anticoagulant therapy can switch to TIPS. The Drum Tower Severity Score (DTSS) system can be used during treatment to evaluate the severity of the disease, in order to identify high-risk patients earlier and switch to TIPS in time, thereby improving the prognosis of patients.
