TIPS术后肝性脑病的研究进展
Research Progress on Hepatic Encephalopathy after TIPS
摘要: 经颈静脉肝内门体分流术(TIPS)虽显著改善了门脉高压患者的预后，但术后肝性脑病(HE)仍是限制其广泛应用的主要并发症。其发病机制复杂，门静脉压力梯度(PPG)过度降低、肠道菌群失调及炎症因子激活都有可能是其核心致病因素；且相关预测因子(如Child-Pugh、MELD)的预测效能也有限；此外肝性脑病缺乏治疗的特效药物。本文旨在整合分析国内外相关文献，探讨TIPS术后HE的风险预测模型、病理机制、预防策略及干预措施。降低TIPS术后HE发生率、改善患者生活质量。
Abstract: Although transjugular intrahepatic portosystemic shunt (TIPS) has significantly improved the prognosis of patients with portal hypertension, postoperative hepatic encephalopathy (HE) remains the primary complication limiting its widespread use. Its pathogenesis is complex; excessive reduction in the portal-peripheral pressure gradient (PPG), gut microbiota dysbiosis, and activation of inflammatory factors may all be core pathogenic factors. Furthermore, the predictive value of relevant prognostic factors (such as Child-Pugh and MELD scores) is limited; additionally, there are no specific drugs available for the treatment of hepatic encephalopathy. This article aims to conduct a systematic review of relevant domestic and international literature to explore risk prediction models, pathophysiological mechanisms, prevention strategies, and intervention measures for HE following TIPS. The goal is to reduce the incidence of post-TIPS HE and improve patients’ quality of life.
文章引用：范惠敏, 张大志. TIPS术后肝性脑病的研究进展[J]. 临床医学进展, 2026, 16(7): 663-673. https://doi.org/10.12677/acm.2026.1672573

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