经颈静脉肝内门体分流术治疗肝硬化并发脾功能亢进症患者疗效研究

doi:10.3969/j.issn.1672-5069.2026.02.029

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 277-280.doi: 10.3969/j.issn.1672-5069.2026.02.029

经颈静脉肝内门体分流术治疗肝硬化并发脾功能亢进症患者疗效研究

何阳, 张屹俊, 侯毅斌, 周粟, 杨柏帅, 袁敏

201508 上海市公共卫生临床中心介入科(何阳,侯毅斌,周粟,杨柏帅);放射科(张屹俊);同济大学附属第十人民医院介入血管科(袁敏)

收稿日期:2025-04-28 出版日期:2026-03-10 发布日期:2026-03-13
通讯作者: 袁敏,E-mail:iryuanmin@tongji.edu.cn
作者简介:何阳,男,31岁,硕士研究生,医师。主要从事肝脏疾病相关介入诊断与治疗学研究。E-mail:heyang@shaphc.org;共同第一作者:张屹俊,男,40岁,大学本科,主管技师。主要从事放射检查与影像学技术优化研究。E-mail:dott147@126.com

Clinical effectiveness of transjugular intrahepatic portosystemic shunt in treatment of patients with liver cirrhosis and hypersplenism

He Yang, Zhang Yijun, Hou Yibin, et al

Department of Interventional Radiology, Public Health Clinical Center, Fudan University, Shanghai 201508, China

Received:2025-04-28 Online:2026-03-10 Published:2026-03-13

摘要/Abstract

摘要： 目的探讨经颈静脉肝内门体分流术(TIPS)治疗肝硬化并发脾功能亢进症患者的疗效。方法 2021年3月～2023年8月上海市公共卫生临床中心诊治的肝硬化并发脾功能亢进症患者62例,均接受TIPS术治疗,术中测量门静脉压力梯度(PPG),行腹部CT检查,应用uAI Research Portal软件测量并计算脾脏体积。结果本组62例患者均获得TIPS术成功;术前,本组患者红细胞计数为(3.5±0.7)×10¹²/L,在术后1年升高至(3.8±0.8)×10¹²/L(P＜0.05),血红蛋白为(97.9±23.2)g/L,在术后3个月和1年分别升高至(108.9±19.0)g/L和(117.4±22.4)g/L(P＜0.05),而术前术后外周血白细胞和血小板计数无显著变化(P>0.05);本组患者术后1年,肝功能指标呈恶化趋势;在TIPS术支架放入前,PPG为(23.3±6.8)mmHg,支架置入后为(8.3±3.5)mmHg;在术前,脾脏体积为(1039.8±561.9)cm³,术后3个月为(900.9±489.8)cm³,术后1年为(930.4±589.4)cm³。结论 TIPS术不能改善肝硬化患者脾功能亢进症导致的血细胞减少,其对预防消化道出血的作用还需要观察。

关键词: 肝硬化, 脾功能亢进症, 经颈静脉肝内门体分流术, 脾脏体积, 治疗

Abstract: Objective The aim of this study was to investigate the clinical effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of patients with liver cirrhosis (LC) and hypersplenism. Methods 62 patients with various etiologies-derived LC were encountered in Shanghai Public Health Clinical Center between March 2021 and August 2023, and all underwent TIPS. Portal pressure gradient (PPG) was measured during the operation, and spleen volume was calculated by uAI Research Portal software based on CT scan. Results The operation was successful in all patients with our series; red blood cell count at presentation was(3.5±0.7)×10¹²/L, it increased to (3.8±0.8)×10¹²/L(P＜0.05) by end of one year follow-up, and hemoglobin was (97.9±23.2)g/L, it increased to(108.9±19.0)g/L by three months, and to (117.4±22.4)g/L(P＜0.05) by end of one-year, while there was no significant changes as respect to white blood cell and platelet counts in our series(P>0.05); liver function test deteriorated in our series during one-year follow-up; the PPG at presentation was (23.3±6.8)mmHg, while it decreased to (8.3±3.5)mmHg after TIPS; before TIPS, the spleen volume was (1039.8±561.9)cm³, it turned to (900.9±489.8)cm³ by end of three-month and to (930.4±589.4)cm³ by end of one-year after TIPS. Conclusion TIPS couldn’t ameliorate hypersplenism, and its role on prevention of varies bleeding is still under observation.

Key words: Liver cirrhosis, Hypersplenism, Transjugular intrahepatic portosystemic shunt, Spleen volume, Therapy

何阳, 张屹俊, 侯毅斌, 周粟, 杨柏帅, 袁敏. 经颈静脉肝内门体分流术治疗肝硬化并发脾功能亢进症患者疗效研究[J]. 实用肝脏病杂志, 2026, 29(2): 277-280.

He Yang, Zhang Yijun, Hou Yibin, et al. Clinical effectiveness of transjugular intrahepatic portosystemic shunt in treatment of patients with liver cirrhosis and hypersplenism[J]. Journal of Practical Hepatology, 2026, 29(2): 277-280.

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经颈静脉肝内门体分流术治疗肝硬化并发脾功能亢进症患者疗效研究

Clinical effectiveness of transjugular intrahepatic portosystemic shunt in treatment of patients with liver cirrhosis and hypersplenism

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