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首页> 外文期刊>International Journal of Hepatology >The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status
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The Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Portal Hypertension: Current Status

机译：经颈静脉肝内门体分流术治疗门脉高压症的现状

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The transjugular intrahepatic portosystemic shunt (TIPS) represents a major advance in the treatment of complications of portal hypertension. Technical improvements and increased experience over the past 24 years led to improved clinical results and a better definition of the indications for TIPS. Randomized clinical trials indicate that the TIPS procedure is not a first-line therapy for variceal bleeding, but can be used when medical treatment fails, both in the acute situation or to prevent variceal rebleeding. The role of TIPS to treat refractory ascites is probably more justified to improve the quality of life rather than to improve survival, except for patients with preserved liver function. It can be helpful for hepatic hydrothorax and can reverse hepatorenal syndrome in selected cases. It is a good treatment for Budd Chiari syndrome uncontrollable by medical treatment. Careful selection of patients is mandatory before TIPS, and clinical followup is essential to detect and treat complications that may result from TIPS stenosis (which can be prevented by using covered stents) and chronic encephalopathy (which may in severe cases justify reduction or occlusion of the shunt). A multidisciplinary approach, including the resources for liver transplantation, is always required to treat these patients.
机译：经颈静脉肝内门体分流术（TIPS）代表了门静脉高压症并发症的重大进展。在过去的24年中，技术的改进和经验的增加导致临床结果的改善以及对TIPS适应症的更好定义。随机临床试验表明，TIPS手术不是静脉曲张破裂出血的一线治疗方法，但是在急性或预防静脉曲张再出血的药物治疗失败时可以使用。除了具有保留的肝功能的患者外，TIPS治疗难治性腹水的作用可能更合理，以改善生活质量而不是提高生存率。它对肝胸水有帮助，在某些情况下可以逆转肝肾综合征。这是药物无法控制的Budd Chiari综合征的一种好治疗方法。在TIPS之前必须仔细选择患者，并且临床随访对于检测和治疗可能因TIPS狭窄（可通过使用覆膜支架来预防）和慢性脑病（在严重情况下可证明减少或闭塞）而引起的并发症至关重要。分流器）。始终需要采用多学科方法，包括肝移植资源来治疗这些患者。

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