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TIPS治疗食管胃底静脉曲张破裂出血的研究进展
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Abstract:
TIPS手术即经颈静脉肝内门体分流术，属于治疗门静脉高压症所致食管胃底静脉曲张破裂出血的介入手段之一。经颈静脉肝内门体分流术现已成为治疗食管胃底静脉曲张破裂出血的一项重要方法，其临床上适应症较为广泛。TIPS早期受到支架长期通畅性差和肝性脑病发病率增加的困扰，随着医学技术的飞速进步，临床实践技术和支架技术亦有了较快的发展，在食管胃底静脉曲张破裂出血的治疗中，经颈静脉肝内门体分流手术的应用也逐渐得到完善。TIPS术的优势在于对身体的损伤较小，降低门脉压力可靠，从而减少食管胃底静脉出血的风险。目前，它作为药物和/或联合胃镜仍无法控制的再出血的补救性治疗措施已达成共识。
TIPS, namely transjugular intrahepatic portosystemic shunt, is one of the interventional methods to treat esophagogastric variceal bleeding caused by portal hypertension. Transjugular intrahepatic portosystemic shunt has become an important method to treat esophagogastric variceal bleeding, and its clinical indications are wide. In the early stage, TIPS was troubled by poor long-term patency of stents and increased incidence of hepatic encephalopathy. With the rapid progress of medical technology, clinical practice technology and stent technology also developed rapidly. In the treatment of esophagogastric variceal bleeding, the application of transjugular intrahepatic portosystemic shunt was gradually improved. The advantages of TIPS are less damage to the body and reliable reduction of portal vein pressure, thus reducing the risk of esophagogastric variceal bleeding. At present, it has reached a consensus as a remedial treatment for rebleeding which is still uncontrollable by drugs and/or combined gastroscopy.
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