球囊阻断逆行经静脉闭塞术治疗乙型肝炎肝硬化并发胃静脉曲张患者疗效研究OA
Efficacy of balloon-occluded retrograde transvenous obliteration in the treatment of patients with hepatitis B-induced liver cirrhosis and gastric varices
目的 比较研究球囊阻断逆行经静脉闭塞术(BRTO)与经颈静脉肝内门体分流术(TIPS)治疗乙型肝炎肝硬化并发胃静脉曲张(GV)患者的疗效和安全性.方法 2022年1月～2024年6月我院收治的乙型肝炎肝硬化并发GV患者101例,被随机分为观察组51例和对照组50例,分别接受BRTO或TIPS治疗,随访12个月.结果 在随访3月时,观察组GV根除率为84.3％,再次行BRTO治疗后,GV全部被根除(100.0％).对照组GV消失率为10.0％(P＜0.05);在随访6月时,观察组死亡2例,对照组死亡4例;在随访12月时,观察组死亡3例,对照组死亡5例;术后,两组血常规和肝功能指标无显著改善,两组指标变化无统计学差异(P＞0.05).结论 采取BRTO治疗乙型肝炎肝硬化并发GV患者,手术技术要求高,消除GV效果确实,其在防治食管胃底静脉曲张破裂出血方面的效果还需要观察.
Objective This study aimed to retrospectively evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration(BRTO)in patients with hepatitis B-induced liver cirrhosis(LC)complicated by gastric varices(GV).Methods A total of 101 patients with hepatitis B-induced LC and complicated GV were encountered in our hospital between January 2022 and June 2024,and were randomly divided into two groups,underwent BRTO in observation group(n=51)or transjugular intrahepatic portosystemic shunt(TIPS)in control group(n=50).All patients were followed-up for one year after operation.Results By end of three-month of follow-up,eradication rate of GV in the observation group was 84.3％and second BRTO eradicated all GV,while GV disappeared in 5 cases(10.0％,P＜0.05)in the control;by end of six-month of follow-up,two patients in the observation and four patients in the control died;by end of one-year of follow-up,three cases in BRTO-treated patients and five cases in TIPS-treated died;after operations,the liver function tests and hypersplenism didn't improved and the related parameter were not significantly different between the two groups(P＞0.05).Conclusion BRTO demonstrates safe and a favorable GV eradication rate in the treatment of patients with hepatitis B-induced LC,which might needs sophisticated procedural skills,and the long-term efficacy on prophylactic GV bleeding is still observed.
段后张;郑扬;陈旭峰;汤小龙;汪程龙
214000 江苏省无锡市 解放军联勤保障部队第904医院消化内科214000 江苏省无锡市 解放军联勤保障部队第904医院消化内科214000 江苏省无锡市 解放军联勤保障部队第904医院消化内科214000 江苏省无锡市 解放军联勤保障部队第904医院消化内科南京医科大学第三附属医院消化内科
肝硬化胃静脉曲张球囊阻断逆行经静脉闭塞术经颈静脉肝内门体分流术治疗
Liver cirrhosisGastric varicesBalloon-occluded retrograde transvenous obliterationTransjugular intrahepatic portosystemic shuntTherapy
《实用肝脏病杂志》 2026 (1)
81-84,4
江苏省科技厅社会发展面上基金资助项目(编号:BE2020775)
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