球囊阻断逆行静脉血管栓塞术在肝硬化并发症治疗中的应用

辛丽霞; 朱洪宾; 刘笑; 张春清

doi:10.12449/JCH260228

球囊阻断逆行静脉血管栓塞术在肝硬化并发症治疗中的应用

DOI: 10.12449/JCH260228

辛丽霞¹,
朱洪宾²,
刘笑¹,
张春清^2, , ,

1.
山东省立医院消化内科，山东大学医学融合与实践中心，济南 250012
2.
山东第一医科大学附属省立医院消化内科，济南 250021

基金项目:

国家自然科学基金 (81970533)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：辛丽霞负责查阅、筛选文献，撰写论文；朱洪宾、刘笑辅助筛选文献；张春清负责论文撰写指导、审阅，最后定稿。

详细信息

通信作者:
张春清， ZHANG Chunqing_sdu@163.com （ORCID： 0000-0001-8711-1579）

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出版历程
- 收稿日期: 2025-05-20
- 录用日期: 2025-08-27
- 出版日期: 2026-02-25

Application of balloon-occluded retrograde transvenous obliteration in treatment of liver cirrhosis complications

1.
Department of Gastroenterology，Shandong Provincial Hospital，Medical Integration and Practice Center of Shandong University，Jinan 250012，China
2.
Department of Gastroenterology，Shandong Provincial Hospital Affiliated to Shandong First Medical University，Jinan 250021，China

Research funding:

National Natural Science Foundation of China (81970533)

More Information

Corresponding author: ZHANG Chunqing， zhangchunqing_sdu@163.com （ORCID： 0000-0001-8711-1579）

摘要

摘要: 胃静脉曲张破裂出血与肝性脑病是肝硬化失代偿期常见且危及生命的并发症。球囊阻断逆行静脉血管栓塞术作为一种微创介入技术，近年来在胃静脉曲张和肝性脑病的临床管理中取得显著进展。本文系统综述球囊阻断逆行静脉血管栓塞术的技术原理、适应证（如孤立性胃静脉曲张、难治性肝性脑病）、临床疗效（急性出血止血率85%～95%、1年再出血率<15%、肝性脑病改善率60%～80%）及安全性（包括肾功能损伤和门静脉压力升高等并发症）。同时，探讨球囊阻断逆行静脉血管栓塞术与传统治疗方式（如经颈静脉肝内门体分流术、内镜治疗）的利弊，并评述近年来的最新技术改良，如金属圈辅助逆行经静脉闭塞术、血管塞辅助逆行经静脉闭塞术。未来研究方向应聚焦于患者选择的精准化（如基于血流动力学参数的分层）、栓塞材料的优化（如新型可降解栓塞剂的应用）及个体化治疗方案的制订，从而在提高疗效的同时降低并发症风险。
- 气囊阻塞 /
- 肝硬化 /
- 食管和胃静脉曲张 /
- 肝性脑病
Abstract: Gastric variceal rupture and bleeding and hepatic encephalopathy are common and life-threatening complications in decompensated cirrhosis. As a minimally invasive interventional technique， balloon-occluded retrograde transvenous obliteration （BRTO） has made significant progress in the clinical management of gastric varices and hepatic encephalopathy in recent years. This article systematically reviews the technical principles， indications （e.g.， isolated gastric varices and refractory hepatic encephalopathy）， clinical efficacy （an acute hemostasis rate of 85% — 95%， a 1-year rebleeding rate of <15%， and an improvement rate of 60% — 80% for hepatic encephalopathy）， and safety （including complications such as renal impairment and elevated portal vein pressure） of BRTO. Meanwhile， this article discusses the advantages and disadvantages of BRTO and conventional treatment modalities （e.g.， transjugular intrahepatic portosystemic shunt and endoscopic treatment） and reviews the latest technological improvements in recent years， such as coil-assisted retrograde transvenous obliteration and plug-assisted retrograde transvenous obliteration. Future research should focus on the precision of patient selection （e.g.， stratification based on hemodynamic parameters）， the optimization of embolic materials （e.g.， application of new biodegradable embolic agents）， and the development of individualized treatment regimens， so as to improve efficacy and reduce the risk of complications.
- Balloon Occlusion /
- Liver Cirrhosis /
- Esophageal and Gastric Varices /
- Hepatic Encephalopathy

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参考文献(51)

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