三种支架用于经颈静脉肝内门体静脉分流术的安全性及疗效分析

发布时间：2018-08-02 14:55

【摘要】：目的探讨不同支架在经颈静脉肝内门体静脉分流(TIPS)术治疗肝硬化门静脉高压中的安全性、有效性。方法收集因肝硬化门静脉高压在我院初次接受TIPS的患者1 086例,将患者分为裸支架组(A组)、覆膜支架组(B组)和双支架组(C组),分析并比较3组患者术后2年内分流道失效率、术后再出血发生率、总生存率及主要并发症发生率。结果 1 086例患者共置入支架1 690枚,TIPS术技术成功率为100%。2.53%(10/396)的急诊患者在围手术期因不可控的上消化道出血死亡;2.78%(11/396)的急诊患者因急性肝功能衰竭死亡,0.84%(5/593)出血停止期患者因急性肝功能衰竭死亡。A、B、C组患者2年总生存率分别为83.78%(186/222)、88.36%(281/318)、96.34%(526/546),差异有统计学意义(χ2=4.15,P=0.04)。A、B、C组分流道失效率分别为39.64%(88/222)、22.33%(71/318)、11.17%(61/546),差异有统计学意义(χ2=4.15,P=0.04)。A、B、C组TIPS术后再出血率分别为31.53%(70/222)、16.89%(54/318)、7.14%(39/546),差异有统计学意义(χ2=9.91,P=0.01);A、B、C组肝性脑病发生率分别为21.62%(48/222)、22.96%(73/318)、19.23%(105/546),差异无统计学意义(χ2=1.00,P=0.06)。结论 TIPS术可有效缓解患者门静脉高压及其并发症,选择直径8mm分流通道,并采用双支架技术可提高TIPS治疗的安全性、有效性。
[Abstract]:Objective to evaluate the safety and efficacy of different stents in the treatment of cirrhotic portal hypertension by transjugular intrahepatic portal vein shunt (TIPS). Methods 1 086 patients who received TIPS for the first time in our hospital due to portal hypertension were divided into three groups: bare stent group (group A), covered stent group (group B) and double stent group (group C). The incidence of postoperative rebleeding, overall survival rate and the incidence of major complications. Results among 1 086 patients, 1 690 stents were successfully implanted with tips. The success rate was 100% (10 / 396). 2.78% (11 / 396) of emergency patients died of uncontrollable upper gastrointestinal bleeding during perioperative period, and 0.84% (5 / 593) of emergency patients died of acute hepatic failure. 鎮ｈ，

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