经不同血管路径行肝静脉压力梯度测定的对照研究

肝脏 ›› 2020, Vol. 25 ›› Issue (8): 800-802.

经不同血管路径行肝静脉压力梯度测定的对照研究

陈广, 王宇, 金龙, 尉建安, 胡跃峰, 曹沙沙

100050 北京首都医科大学附属北京友谊医院放射介入科(陈广,金龙,尉建安,胡跃峰,曹沙沙),肝病中心国家消化系统疾病临床医学研究中心(王宇)

收稿日期:2020-03-25 出版日期:2020-08-31 发布日期:2020-09-04
通讯作者: 金龙,Email:longerg@hotmail.com
基金资助:
北京市医院管理中心消化内科学科协同发展中心专项经费资助(XXT04)

A comparison of different intravascular approaches for measuring hepatic venous pressure gradient

CHEN Guang¹, WANG Yu², JIN Long^1*, WEI Jian-an¹, HU Yue-feng¹, CAO Sha-sha¹

1. Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
2. Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

Received:2020-03-25 Online:2020-08-31 Published:2020-09-04
Contact: JIN Long, Email: longerg@hotmail.com

摘要/Abstract

摘要： 目的比较颈内静脉路径方法和改良式股静脉路径法的插管时间及并发症发生率。方法选取2017年12月至2019年12月于北京友谊医院行肝静脉压力梯度测定的60例患者,按随机数表法分为两组,每组30例。改良式股静脉路径组采用7F的RDC guiding导管配合5.5F双腔球囊导管行肝静脉压力梯度测定。观察颈内静脉路径组和改良式股静脉路径组的所需插管时间和并发症发生率。结果 60例患者的球囊导管置管全部成功,改良式股静脉路径组成功插管平均透视时间为(145±25) s,明显少于颈内静脉路径组的(227±34) s,差异有统计学意义(t=10.511,P<0.01)。改良式股静脉路径组操作引发的室上性心动过速发生率(3.33%;1/30)明显少于颈内静脉路径(36.67%,11/30)(χ²=21.600,P<0.01),改良式股静脉路径组操作引发的焦虑紧张发生率(6.67%,2/30)明显少于颈内静脉路径(23.33%,7/30)(χ²=29.400,P<0.01)。结论对于单纯行HVPG测量的患者,改良式股静脉路径法能缩短手术时间,是安全快捷的基本满足临床需要的操作方法。

关键词: 肝静脉压力梯度, 经颈静脉, 经股静脉

Abstract: Objective To investigate an optimized method for measuring hepatic venous pressure gradient (HVPG). The consuming time and the incidence of complications between the transjugular and the modified transfemoral methods were compared. Methods Sixty patients who received HVPG measurement at Beijing Friendship Hospital, Capital Medical University between December 2017 to December 2019 were studied. They were divided into two groups (with 30 cases in each group) according to a random number table. The HVPG in one group of patients were measured with the modified transfemoral method, using 7F RDC guiding catheter in combination with 5.5F double-lumen balloon catheter. The consuming time of catheterization and the incidence of complications between the transjugular group and the modified transfemoral group were compared. Results HVPG was successfully measured in all 60 subjects. The average catheterization time (145±25)s in the modified transfemoral group was less than that in the transjugular group (227±34)s(t=10.511,P=0.000),The incidence rate of supraventricular tachycardia in the modified transfemoral group (3.33%) was lower than that in the transjugular group (36.67%)(χ²=21.600,P=0.000), The incidence rate of anxiety in the modified transfemoral group (6.67%) was lower than that in the transjugular group (23.33%)(χ²=29.400,P=0.000, all have statistical significant differences. Conclusion For measuring HVPG, the modified transfemoral method may shorten the operating time, and therefore is a safety and clinically desirable approach.

Key words: Hepatic venous pressure gradient, Transjugular method, Modified transfemoral method

陈广, 王宇, 金龙, 尉建安, 胡跃峰, 曹沙沙. 经不同血管路径行肝静脉压力梯度测定的对照研究[J]. 肝脏, 2020, 25(8): 800-802.

CHEN Guang, WANG Yu, JIN Long, WEI Jian-an, HU Yue-feng, CAO Sha-sha. A comparison of different intravascular approaches for measuring hepatic venous pressure gradient[J]. Chinese Hepatolgy, 2020, 25(8): 800-802.

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