门静脉高压介入性精准分流
Interventional precision shunting for portal hypertension
马婧嵌 1罗剑钧 1颜志平1
作者信息
- 1. 200032 上海 复旦大学附属中山医院介入治疗科、国家放射与治疗临床研究中心、上海市影像医学研究所
- 折叠
摘要
门静脉高压是门静脉压力梯度(portal pressure gradient,PPG)病理性升高,常导致严重并发症.介入性分流如经颈静脉肝内门体分流术已逐渐成为重要治疗手段,但患者术后血流动力学变化不确定,需要精准分流以实现个体化治疗.精准分流旨在平衡分流量与肝组织血液灌注,在缓解症状的同时最小化并发症.介入性分流术后血流动力学目标确定受多种因素影响,合理的术后血流动力学目标(合理PPG)应综合考虑术式差异与个体差异.精准分流初步临床实践强调对术前门静脉压力的准确测量以及对术后血流动力学状态的有效监测.未来研究应进一步完善介入性分流技术,以实现更为个体化和精准的治疗.
Abstract
Portal hypertension is a pathological elevation of portal pressure gradient(PPG),often leading to severe complications.Interventional shunting such as transjugular intrahepatic portosystemic shunt(TIPS)has gradually become an important means of treatment,but the postoperative hemodynamic changes are uncertain,therefore,individualized treatment scheme with precision shunting is needed.The purpose of precision shunting is to balance the amount of shunting blood with the amount of blood perfusion in the liver tissue,which can minimize the incidence of complications while relieving symptoms.The determination of hemodynamic goals after interventional shunting is influenced by various factors,and the procedural differences and individual variances should be taken into consideration when making reasonable postoperative hemodynamic targets(optimal PPG).The preliminary results of clinical practice of precision shunting indicates that accurate measurement of preoperative portal pressure and effective monitoring of postoperative hemodynamic status should be emphasized.Future studies should further improve the interventional shunting technique to achieve a more individualized precision treatment.
关键词
介入性分流/经颈静脉肝内门体分流术/精准分流/门静脉高压/门静脉压力梯度Key words
interventional shunting/transjugular intrahepatic portosystemic shunt/precision shunting/portal hypertension/portal pressure gradient引用本文复制引用
出版年
2024
NETL
NSTL
万方数据