TIPSS术使用组合支架与Viatorr支架治疗肝硬化并发门静脉高压症患者长期疗效比较  

Combined stents versus Viatorr stents in transjugular intrahepatic portosystemic stent shunt for treatment of patients with liver cirrhosis and complicated portal hypertension

作　　者：鲍应军 张媛[2] 顾俊鹏[1] 朱帝文[1] 张海潇[1] 曹耿飞 阿斯哈尔·哈斯木 任伟新[1] Bao Yingjun;Zhang Yuan;Gu Junpeng(Department of Interventional Radiology,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第一附属医院介入放射科,乌鲁木齐市830054 [2]新疆医科大学附属肿瘤医院超声诊断科,乌鲁木齐市830054

出　　处：《实用肝脏病杂志》2024年第4期583-586,共4页Journal of Practical Hepatology

基　　金：新疆维吾尔自治区“天池英才”青年博士资助项目(编号:2020001)。

摘　　要：目的探讨经颈静脉肝内门体静脉分流术(TIPSS)中使用组合支架与Viatorr支架的长期疗效。方法2013年7月~2022年8月新疆医科大学第一附属医院介入治疗中心诊治的肝硬化并发门静脉高压症患者51例,均接受TIPSS术治疗,其中使用组合支架29例,使用Viatorr支架22例。术后随访5年。使用影像学检查肝内分流道通畅情况,应用Kaplan-Meler法分析比较两组分流道累积通畅率和生存率。结果使用Viatorr支架手术花费为73282.9(68190.6,81242.2)元,显著高于使用组合支架【61912.7(53713.6,67530.3)元,P<0.05】;第一年、二年、三年、四年和五年,Viatorr支架组肝内分流道累积通畅率分别为90.9%、77.3%、72.7%、71.4%和68.4%,组合支架组分别为86.7%、80.0%、76.7%、73.3%和70.0%,两组无统计学差异(P>0.05);Viatorr支架组累计生存率分别为95.5%、77.3%、72.7%、68.2%和59.1%,组合支架组分别为93.3%、86.7%、83.3%、83.3%和79.9%,两组无统计学差异(P>0.05)。结论本组资料显示,在行TIPSS手术时使用组合支架或Viatorr支架均可获得较好的临床效果,可根据供给情况选择使用。Objective This study was conducted to investigate the long-term efficacy of combined stents and Viatorr stents in transjugular intrahepatic portosystemic stent shunt(TIPSS)for treatment of patients with liver cirrhosis(LC)and complicated portal hypertension(PH).Methods All patients in our series underwent TIPSS,29 patients were assigned to combined stents and 22 to Viatorr stents and all were followed-up for five years.The patency of the intrahepatic shunts were check-up by ultrasonography or/and CT scan.The survival was compared by Kaplan-Meier method.Results The operational costs in patients in Viatorr group was 73282.9(68190.6,81242.2)yuan,much greater than[61912.7(53713.6,67530.3)yuan,P<0.05]in patients in combined stents;at the end of one,two,three,four and five years after TIPSS,the cumulative patency of intrahepatic stents in patients with Viatorr were 90.9%,77.3%,72.7%,71.4%and 68.4%,and they were 86.7%,80.0%,76.7%,73.3%and 70.0%in patients with combined stents,not significantly different between the two groups(P>0.05);the cumulative survival rates in patients with Viatorr stent were 95.5%,77.3%,72.7%,68.2%and 59.1%,also not significantly different as compared to 93.3%,86.7%,83.3%,83.3%and 79.9%in patients with combined stents(P>0.05).Conclusion We recommend the choice of combined stents or Viatorr stents for TIPSS surgery as the supply available,as the two have a relatively similar promising efficacy in dealing with cirrhotics with PH.

关 键 词：肝硬化 门脉高压症 经颈静脉肝内门体静脉分流术 组合支架 Viatorr支架 治疗 

分 类 号：R575.2[医药卫生—消化系统]