经颈静脉肝内门静脉系统分流术后肝性脑病发生率的多因素分析

中国综合临床 Pub Date : 2019-11-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2019.06.005

Xudong Gao, Kun Yang, Keming Zhang, H. Yao, Wen-lin Bai, Junhua Zhang

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引用次数: 0

摘要

目的分析经颈静脉肝内门体分流术（TIPS）肝硬化患者的临床特点与术后肝性脑病发生率的相关性。方法回顾性分析2015年3月至2017年3月在解放军总医院第五医学中心住院的80例肝硬化患者的临床资料。分析TIPS治疗后肝性脑病并发症的相关因素。结果TIPS术后1年肝性脑病累计发生率为23.75%（19/80）。通过单因素分析和多因素Logistic回归分析发现，术前血小板水平和tips分流术后发生肝性脑病的位置两个因素与tips术后肝性脑病发生密切相关。ROC曲线表明术前血小板水平的AUC和尖端血液分流的位置分别为0.657和0.668。前者的敏感性和特异性分别为70.0%、52.6%和51×109/L，后者的敏感性和特异度分别为70.5%和63.2%。结论术前血小板水平＞51×109/L或门静脉左支分流可降低肝性脑病的发生率。关键词：经颈静脉肝内门体分流术；肝性脑病；肝硬化

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Multivariate analysis of the incidence of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt

Objective To analyze the correlation between the clinical characteristics and the incidence of postoperative hepatic encephalopathy in patients with cirrhosis who received transjugular intrahepatic portosystemic shunt (TIPS). Methods The clinical data of 80 patients with liver cirrhosis hospitalized in the Fifth Medical Center of PLA General Hospital from March 2015 to March 2017 were retrospectively analyzed.The related factors of hepatic encephalopathy complications after TIPS treatment were analyzed. Results The cumulative incidence of hepatic encephalopathy was about 23.75% (19/80) in one year after TIPS operation.Through single factor analysis and multi factor Logistic regression analysis, it was found that the two factors of preoperative platelet level and the location of tips blood shunt were closely related to the occurrence of hepatic encephalopathy after TIPS operation.The ROC curve suggested that the AUC of preoperative platelet level and the location of tips blood shunt were 0.657 and 0.668, respectively.The sensitivity and specificity of the former were 70.0%, 52.6% and the cutoff value was 51×109/L, respectively, while those of the latter were 70.5% and 63.2%, respectively. Conclusion Preoperative platelets level>51×109/L or shunting of the left branches of the portal vein may indicate a lower incidence of hepatic encephalopathy. Key words: Transjugular intrahepatic portosystemic shunt; Hepatic encephalopathy; Liver cirrhosis

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.