Viatorr覆膜支架用于TIPS术治疗肝硬化门静脉高压症患者预后研究

Application of Viatorr covered stent in TIPS for treatment of cirrhotics with portal hypertension

目的研究Viatorr覆膜支架用于经颈静脉肝内门体静脉分流术(TIPS)治疗肝硬化门静脉高压症患者的疗效和转归。方法2018年1月~2020年1月我院收治的肝硬化并发门静脉高压症患者146例,采用随机数字表法将患者分为对照组73例和观察组73例,在接受TIPS术治疗时分别使用裸支架联合Fluency覆膜支架或Viatorr覆膜支架。随访12 m。结果观察组手术时间为(99.5±9.8)min,显著短于对照组【(110.0±8.5)min,P<0.05】,术后两组门静脉压力均显著降低,但差异无统计学意义(P>0.05);在术后3 m,两组肝功能指标变化无显著性差异(P>0.05);随访12 m,观察组分流道失效率为1.4%,显著低于对照组的23.3%(P<0.05);观察组死亡5例(6.8%),对照组死亡6例(8.2%,Log-rank值=0.099,P=0.753)。结论相对于裸支架和Fluency覆膜双支架,使用Viatorr覆膜支架行TIPS术治疗肝硬化并发门脉高压症患者能有效缩短手术时间,保持分流道通畅,值得进一步观察。

Objective The aim of this study was to investigate the application of Viatorr coated stent during the transjugular intrahepatic portosystemic shunt(TIPS)in the treatment of patients with liver cirrhosis and portal hypertension.Methods 146 patients with liver cirrhosis and portal hypertension were recruited in our hospital between January 2018 and January 2020,and were randomly divided into control(n=73)and observation(n=73)groups.All patients underwent TIPS,while the bare and the Fluency stent were used in patients in the control and the Viatorr stent was used in the observation.All patients were followed-up for 12 months.Results The operation time in the observation group was(99.5±9.8)min,significantly shorter than[(110.0±8.5)min,P<0.05]in the control,and there was no significant difference in portal vein pressure after operation between the two groups(P>0.05);at the end of 3 months after operation,there were no significant differences as respect to serum hepatic function tests between the two groups(P>0.05);at the end of 12 months,the shunt insufficiency rate in the observation group was 1.4%,significantly lower than 23.3%in the control group(P<0.05);five patients(6.8%)in the observation,and six(8.2%,Log-rank=0.099,P=0.753)in the control died.Conclusion The application of Viatorr covered stent during TIPS for treatment of cirrhotic patients with portal hypertension could effectively shorten the operation time and keep the shunt patency,which warrants further investigation.