双支架技术在经颈静脉肝内门体分流术中的应用

发布时间：2018-05-30 14:56

本文选题：经颈静脉肝内门体分流术 + 支架　；参考：《中国介入影像与治疗学》2017年02期

【摘要】：目的对比分析应用3种支架植入方式[裸支架、覆膜支架、双支架(裸支架+覆膜支架)]行经颈静脉肝内门体分流术(TIPSS)的分流效果、对肝功能的影响和中远期通畅率。方法回顾性分析因肝硬化门静脉高压合并上消化道出血行TIPSS治疗的178例患者的临床资料,比较3种支架的临床疗效、肝功能恢复时间、术后1年一期和二期通畅率。结果 178例患者中,成功植入支架175例,成功率为98.31%(175/178),其中裸支架52例,覆膜支架52例,双支架71例。所有患者的出血均得到控制。裸支架组、覆膜支架组、双支架组肝功能恢复正常时间分别为(5.3±1.4)天、(9.8±1.7)天、(6.2±1.7)天,裸支架组和双支架组与覆膜支架组的差异有统计学意义(P均0.01),裸支架组和双支架组间差异无统计学意义(P0.05)。裸支架组、覆膜支架组和双支架组1年一期通畅率分别为78.84%(41/52)、84.61%(44/52)、90.14%(64/71),两两比较差异均有统计学意义(P均0.01);1年二期通畅率均为100%。结论采用双支架技术行TIPSS技术,对肝功能影响小,可提高中远期通畅率,可作为Viatorr支架的替代选择。
[Abstract]:Objective to compare and analyze the shunt effect of three stents (bare stents, covered stents, double stents (bare stents covered stents) with TIPSS), and the effect of TIPSSs on the liver function and the patency rate in the medium and long term. Methods the clinical data of 178 patients with portal hypertension complicated with upper gastrointestinal bleeding due to cirrhosis were analyzed retrospectively. The clinical effects of three stents, the recovery time of liver function, and the patency rate of one year and two stages after operation were compared. Results among 178 patients, 175 cases were stents successfully implanted, the success rate was 98.31% 17.5% 178%, including 52 cases of bare stents, 52 cases of covered stents and 71 cases of double stents. Bleeding was controlled in all patients. The recovery time of liver function in bare stent group, covered stent group and double stent group were 5.3 卤1.4 days and 9.8 卤1.7 days respectively. There was significant difference between bare stent group and double stent group and covered stent group (P < 0.01), but there was no significant difference between bare stent group and double stent group (P 0.05). The one-stage patency rates of bare stent group, covered stent group and double stent group were 78.84% and 84.61%, respectively, and the differences were statistically significant (P < 0.01). Conclusion double stent TIPSS technique has little effect on liver function and can improve the patency rate in medium and long term. It can be used as an alternative to Viatorr stent.
【作者单位】：白求恩国际和平医院放射科;
【分类号】：R657.3

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