【摘要】：目的探討不同支架在經(jīng)頸靜脈肝內(nèi)門(mén)體靜脈分流(TIPS)術(shù)治療肝硬化門(mén)靜脈高壓中的安全性、有效性。方法收集因肝硬化門(mén)靜脈高壓在我院初次接受TIPS的患者1 086例,將患者分為裸支架組(A組)、覆膜支架組(B組)和雙支架組(C組),分析并比較3組患者術(shù)后2年內(nèi)分流道失效率、術(shù)后再出血發(fā)生率、總生存率及主要并發(fā)癥發(fā)生率。結(jié)果 1 086例患者共置入支架1 690枚,TIPS術(shù)技術(shù)成功率為100%。2.53%(10/396)的急診患者在圍手術(shù)期因不可控的上消化道出血死亡;2.78%(11/396)的急診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組患者2年總生存率分別為83.78%(186/222)、88.36%(281/318)、96.34%(526/546),差異有統(tǒng)計(jì)學(xué)意義(χ2=4.15,P=0.04)。A、B、C組分流道失效率分別為39.64%(88/222)、22.33%(71/318)、11.17%(61/546),差異有統(tǒng)計(jì)學(xué)意義(χ2=4.15,P=0.04)。A、B、C組TIPS術(shù)后再出血率分別為31.53%(70/222)、16.89%(54/318)、7.14%(39/546),差異有統(tǒng)計(jì)學(xué)意義(χ2=9.91,P=0.01);A、B、C組肝性腦病發(fā)生率分別為21.62%(48/222)、22.96%(73/318)、19.23%(105/546),差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=1.00,P=0.06)。結(jié)論 TIPS術(shù)可有效緩解患者門(mén)靜脈高壓及其并發(fā)癥,選擇直徑8mm分流通道,并采用雙支架技術(shù)可提高TIPS治療的安全性、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(zhèn)ｈ，

本文編號(hào)：2159798