自发性移植系统的有效性和安全性避免了肝脏脑病的栓塞:一个元分析
Xing Wang1, Zhengyu Wang1, Bohan Luo1
1Department of Liver Diseases and Interventional Radiology, Xi'an International Medical Center Hospital of Digestive Diseases, Northwest University, Xi'an 710032, China (X.W., Z.W., B.L., G.H.).
Academic radiology
|October 29, 2025
概括
自发性移植系统分流 (SPSS) 栓塞有效治疗耐火性肝脑病变 (HE),缓解率为83.1%. 虽然通常是安全的,但长期的并发症,如炎和水进展发生,需要个性化的技术选择.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 耐火性肝脑病变 (HE) 在肝硬化患者中构成了重大挑战.
- 自发的港口系统性分流 (SPSS) 是一个未被认可的HE的原因.
- SPSS栓塞为HE管理提供了一个潜在的治疗途径.
研究的目的:
- 系统地审查和元分析SPSS栓塞在肝硬化患者中对HE的疗效和安全性.
- 评估临床成功,手术成功和并发症率.
- 为了比较不同栓塞技术的结果.
主要方法:
- 在PubMed,科学网,Embase和Cochrane图书馆进行系统的文献搜索,截至2024年6月12日.
- 对包括289名患者在内的10项回顾性研究的元分析.
- 固定效应或随机效应模型用于汇集关于HE缓解,程序成功和并发症的数据.
主要成果:
- 观察到83.1%的HE缓解率和99.8%的程序成功率.
- 长期并发症发生在42.9%的患者中,主要是,水进展和血栓形成.
- 气球封闭逆向透静脉消灭 (BRTO) 显示出最高的疗效 (97.4%-100%).
结论:
- SPSS栓塞是一种高度有效的耐火性HE治疗方法,程序成功率很高.
- 虽然长期并发症很明显,但SPSS栓塞是一种可行的治疗选择.
- 在等待进一步的研究之前,建议选择个性化的技术,可能有利于BRTO.
相关概念视频
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
210
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
210
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
179
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
179
Esophageal Varices-II: Clinical Features and Management
359
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
359
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
308
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
308


