| 摘要: |
| ［摘要］ 肝硬化门静脉高压将导致严重并发症如食管胃静脉曲张破裂出血、顽固性腹水、门静脉血栓等，严重影响患者生活质量以及生存期。经颈静脉肝内门体分流术（TIPS）能够显著降低门静脉压力，但是该治疗手段对于患者的受益程度、治疗时机以及适应证存在一定争议。该文简述了TIPS手术的历史起源、临床实践中地位演变以及当前世界各地指南共识等方面，着重讨论TIPS处理的时机以及适应证，回顾了目前诸多临床队列研究结论观点，并对早期TIPS（early TIPS）相关的治疗提出了展望。 |
| 关键词: 门脉高压 食管胃静脉曲张破裂出血 早期TIPS 优先TIPS |
| DOI：10.3969/j.issn.1674-3806.2021.08.04 |
| 分类号:R 657.3+4 |
| 基金项目:四川省医学会静脉血栓栓塞症防治（恒瑞）专项科研课题（编号：2019HR29） |
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| New direction of treatment for portal hypertension: early transjugular intrahepatic portosystemic shunt |
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ZHU Qing-liang, LEI Jia-ming
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Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Sichuan 646000, China
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| Abstract: |
| ［Abstract］ Portal hypertension(PH) in liver cirrhosis may lead to serious complications, such as esophagogastric variceal bleeding(EVB), refractory ascites(RA) and portal vein thrombosis(PVT), which seriously affect the patients′ quality of life and survival. Transjugular intrahepatic portosystemic shunt(TIPS) can significantly reduce portal vein pressure. However, certain controversies exist regarding the benefits of this treatment for the patients, timing of treatment and indications. This paper briefly describes the historical origin of TIPS surgery, the evolution of its status in clinical practice and the current consensuses and guidelines around the world, focuses on the timing and indications of TIPS treatment, reviews the conclusions and views of many current clinical cohort studies, and puts forward the prospect of early TIPS related treatment. |
| Key words: Portal hypertension(PH) Esophagogastric variceal bleeding(EVB) Early transjugular intrahepatic portosystemic shunt(TIPS) Pre-emptive transjugular intrahepatic portosystemic shunt(pre-emptive TIPS) |
