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Joseph Valamparampil¹, Rachel M Brown², Simon McGuirk³

¹Liver Unit (including small bowel transplantation), Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.

Journal of pediatric gastroenterology and nutrition

|February 28, 2025

概括

肝静脉压梯度 (HVWPG) 测量有助于评估患有肠衰竭相关肝病 (IFALD) 的儿童的门脉高血压. 这有助于决定包括肝脏在内的肠移植,特别是那些有桥梁纤维化但没有明显的门高血压临床症状的人.

科学领域:

儿科胃肠病学儿科胃肠病学
肝病学肝病学是一种肝病学.
移植手术移植手术

背景情况:

儿童的肠衰竭相关性肝病 (IFALD) 在评估肝病严重程度和门性高血压方面可能会带来挑战.
评估门高血压的传统方法可能会在IFALD患者中产生误导作用.
肝静脉压梯度 (HVWPG) 是用于评估其他慢性肝病的门高血压的验证工具.

研究的目的:

评估HVWPG在评估IFALD儿童门性高血压严重性的有用性.
确定HVWPG测量是否可以帮助IFALD患者的肝脏包括肠道移植的决策过程.

主要方法:

在2005年至2020年期间,对23名患有IFALD的儿童进行了HVWPG测量后期分析.
根据HVWPG对患者进行了分类:<10 mmHg (无显著门高血压) 和≥10 mmHg (显著门高血压).
审查了临床结果,实验室参数和肝脏活检发现.

主要成果:

在23名儿童中,16名儿童的HVWPG<10 mmHg,而7名儿童的HVWPG≥10 mmHg.
患有显著门性高血压 (HVWPG ≥10 mmHg) 的儿童主要被推接受包括肝脏在内的肠移植.
四名桥梁纤维化和HVWPG<10 mmHg的儿童在重复测量时显示HVWPG增加,导致移植建议.

结论:

在IFALD儿童中,HVWPG测量对于客观评估门高血压很有价值.
HVWPG可以指导决定是否需要包括肝脏在内的肠移植.
这对于患有桥梁纤维化但没有明显的门高血压临床症状的IFALD患者尤其重要.

关键词:

肠道衰竭是指肠道的衰竭.肠道移植肠道移植肝脏和小肠移植移植小肠移植亲肠营养亲肠营养门高血压门高血压

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