抗凝药物在经颈静脉肝内门体分流术后的应用

蒋明远; 黄华; 路明亮; 林凡榆; 张映媛

doi:10.3969/j.issn.1001-5256.2018.10.040

抗凝药物在经颈静脉肝内门体分流术后的应用

DOI: 10.3969/j.issn.1001-5256.2018.10.040

昆明医科大学第二附属医院消化内科

基金项目:

云南省应用基础研究(2015FB059)；

详细信息

中图分类号: R575.2
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- 被引次数: 0
出版历程
- 收稿日期: 2018-04-28
- 出版日期: 2018-10-20

Application of anticoagulants after transjugular intrahepatic portosystemic shunt

Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University

Research funding:

摘要

摘要: 经颈静脉肝内门体分流术(TIPS)经过近30年的不断探索与发展,目前已被广泛应用于治疗门静脉高压并发症,TIPS在急性食管胃底静脉曲张破裂出血、预防再出血、顽固性腹腔积液、布加综合征等方面有明显的优势,但如果术后抗凝措施不当,会引起支架功能障碍、急性血栓形成等并发症,导致TIPS术前门静脉高压症状再现,严重影响了术后中、远期疗效及患者存活率,而维持支架畅通是保证术后疗效的关键,因此抗凝药物在预防和治疗TIPS术后血栓形成显得极为重要,目前关于TIPS术后抗凝治疗国内外还没有达成共识,就TIPS术后抗凝药物应用的研究进展作一综述。
- 门体分流术,经颈静脉肝内 /
- 静脉血栓形成 /
- 抗凝药 /
- 综述
Abstract: Transjugular intrahepatic portosystemic shunt ( TIPS) , after nearly 30 years of continuous exploration and development, has been widely used in the treatment of complications of portal hypertension. TIPS has significant advantages in acute esophagogastric variceal bleeding, prevention of rebleeding, refractory peritoneal effusion, and Budd-Chiari syndrome; however, if postoperative anticoagulant measures are inappropriate, it can cause several complications, such as stent dysfunction and acute thrombosis, and lead to the recurrence of the symptoms of portal hypertension before TIPS, which greatly affects middle-and long-term clinical outcomes and survival rate. Maintenance of stent patency is the key to good postoperative treatment outcome, and therefore, anticoagulants play an important role in the prevention and treatment of post-TIPS thrombosis. At present, no consensus has been reached on post-TIPS anticoagulant therapy in China and foreign countries. This article reviews the research advances in the application of anticoagulants after TIPS.
- portasystemic shunt, transjugular intrahepatic /
- venous thrombosis /
- anticoagulants /
- review

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