目的：观察合经颈内静脉肝内门体分流术（TIPS）后加用特利加压素治疗肝硬化门脉高压食管－胃底静脉曲张破裂出血的疗效。方法选择2011年1月至2013年6月在医院普外中心行TIPS＋特利加压素治疗的肝硬化食－管胃底静脉曲张破裂出血患者48例，设为A组；选择同期医院消化中心行内镜套扎＋奥曲肽治疗的同类患者52例，设为B组。结果两组48 h成功止血率无显著性差异（ P>0.05）；A组6周内再出血率、半年生存率、住院期间死亡率、平均住院日均明显优于B组（ P＜0.05）；术后肝性脑病发生率差异无统计学意义（ P>0.05）。结论 TIPS是治疗门脉高压型消化道出血有效且安全的方法，联合应用特利加压素可协同加强止血效果，进一步降低门脉压，有效预防短期内再出血。%Objective to observe the effect of adding terlipressin after transjugular intrahepatic portosystic shunt ( TIPS ) for treating liver cirrhosis portal hypertension ruptured esophageal gastric varices bleeding. Methods 48 cases of liver cirrhosis portal hypertension rup-tured esophageal gastric varices bleeding in our center from January 2011 to June 2013 treated by TIPS plus terlipressin were selected as the group A; contemporaneous 52 cases of same type patients in the digestion center of our hospital treated by the endoscopic variceal ligation plus octreotide were selected as the group B. The 48 h successful hemostasis rate, re-bleeding rate within 6 weeks, half year survival rate, occurrence rate of postoperative hepatic encephalopathy and in-hospital mortality were compared between the two groups. Results The 48 h successful hemostasis rate had no statistically significant difference between the two groups ( P>0. 05 ); the group A was significantly superior to the group B in the re-bleeding rate within 6 weeks, half year survival rate and in-hospital mortality ( P0. 05 ) . Conclusion TIPS is an effective and safe method for treating portal hypertension digestive tract bleeding, the combined use of terlipressin can synergize the hemostatic effect, further reduce the portal vein pressure and effectively preventing re-bleeding in the short term.
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