{"title":"经颈静脉肝内门静脉系统分流改善难治性腹水肝硬化患者内脏血流动力学和肾钠排泄","authors":"Shuichi Sezai , Mitsuhiro Terada , Masayoshi Ito , Yukihiro Sakurai , Kazuaki Kamisaka , Takashi Abe , Fumiaki Ikegami , Masanori Hirano","doi":"10.1016/S0928-4346(96)00319-2","DOIUrl":null,"url":null,"abstract":"<div><p>To clarify the pathogenesis of ascites in patients with liver cirrhosis, we explored the effects of transjugular intrahepatic portosystemic shunting in six cirrhotic patients with refractory ascites. The portal pressure decreased from 39 ± 7 cmH<sub>2</sub>O before treatment to 32 ± 5 cmH<sub>2</sub>O immediately after the procedure. Liver function transiently deteriorated after the procedure, but recovered within 1 week. Urinary Na excretion increased 1 week after treatment. In five patients, ascites improved within 3 weeks. Along with the decrease of portal congestion, there was an improvement of esophageal varices, and an increase of gastric mucosal blood flow, and an inhibition of the renin-angiotensin-aldosterone system in all of the patients after 2–4 weeks. Manageable shunt encephalopathy occurred in three patients. These findings strongly suggest the pivotal role of increased portal pressure in the formation of ascites in patients with liver cirrhosis.</p></div>","PeriodicalId":13746,"journal":{"name":"International Hepatology Communications","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1996-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0928-4346(96)00319-2","citationCount":"0","resultStr":"{\"title\":\"Transjugular intrahepatic portosystemic shunting improves splanchnic hemodynamics and renal Na excretion in cirrhosis with refractory ascites\",\"authors\":\"Shuichi Sezai , Mitsuhiro Terada , Masayoshi Ito , Yukihiro Sakurai , Kazuaki Kamisaka , Takashi Abe , Fumiaki Ikegami , Masanori Hirano\",\"doi\":\"10.1016/S0928-4346(96)00319-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>To clarify the pathogenesis of ascites in patients with liver cirrhosis, we explored the effects of transjugular intrahepatic portosystemic shunting in six cirrhotic patients with refractory ascites. The portal pressure decreased from 39 ± 7 cmH<sub>2</sub>O before treatment to 32 ± 5 cmH<sub>2</sub>O immediately after the procedure. Liver function transiently deteriorated after the procedure, but recovered within 1 week. Urinary Na excretion increased 1 week after treatment. In five patients, ascites improved within 3 weeks. Along with the decrease of portal congestion, there was an improvement of esophageal varices, and an increase of gastric mucosal blood flow, and an inhibition of the renin-angiotensin-aldosterone system in all of the patients after 2–4 weeks. Manageable shunt encephalopathy occurred in three patients. These findings strongly suggest the pivotal role of increased portal pressure in the formation of ascites in patients with liver cirrhosis.</p></div>\",\"PeriodicalId\":13746,\"journal\":{\"name\":\"International Hepatology Communications\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1996-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/S0928-4346(96)00319-2\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Hepatology Communications\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0928434696003192\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Hepatology Communications","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0928434696003192","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Transjugular intrahepatic portosystemic shunting improves splanchnic hemodynamics and renal Na excretion in cirrhosis with refractory ascites
To clarify the pathogenesis of ascites in patients with liver cirrhosis, we explored the effects of transjugular intrahepatic portosystemic shunting in six cirrhotic patients with refractory ascites. The portal pressure decreased from 39 ± 7 cmH2O before treatment to 32 ± 5 cmH2O immediately after the procedure. Liver function transiently deteriorated after the procedure, but recovered within 1 week. Urinary Na excretion increased 1 week after treatment. In five patients, ascites improved within 3 weeks. Along with the decrease of portal congestion, there was an improvement of esophageal varices, and an increase of gastric mucosal blood flow, and an inhibition of the renin-angiotensin-aldosterone system in all of the patients after 2–4 weeks. Manageable shunt encephalopathy occurred in three patients. These findings strongly suggest the pivotal role of increased portal pressure in the formation of ascites in patients with liver cirrhosis.
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