不同支架肝静脉端形态对经颈静脉肝内门体分流术后疗效的影响

The effect of hepatic venous end morphology of the stent on the curative efficacy after transjugular intrahepatic portosystemic shunt

目的分析经颈静脉肝内门体分流术中分流道支架延伸至下腔静脉肝静脉结合处时,不同分流道支架肝静脉端形态对术后疗效的影响。比较分流道肝静脉端裸支架和覆膜支架的临床疗效、安全性及住院时间。方法回顾性分析2018年5月至2020年10月在航天中心医院介入血管科接受经颈静脉肝内门体分流术治疗的门静脉高压症患者67例,其中分流道肝静脉端裸支架组40例,覆膜支架组27例。比较两组患者的平均住院日、主要不良事件发生率、分流道通畅率、肝性脑病未发生率和生存率。结果两组患者的基线资料和病变特征具有可比性。两组患者的分流道通畅率、肝性脑病未发生率、生存率、平均住院日、主要不良事件发生率的差异均无统计学意义(均P>0.05)。结论不同分流道支架肝静脉端行经颈静脉肝内门体分流术的疗效和安全性相当。

Objective To analyze the influence of the hepatic vein end morphology of the stent on the curative efficacy when the shunt stent extends to the inferior vena cava(IVC)-hepatic vein junction during the transjugular intrahepatic portosystemic shunt(TIPS),and to compare the clinical efficacy,safety and hospitalization days between bare stent and covered stent implanted at the hepatic venous end of the shunt tract.Methods The clinical data of 67 patients with portal hypertension,who received TIPS at the Aerospace Center Hospital of China between May 2018 and October 2020,were retrospectively analyzed.Of the 67 patients,bare stent was implanted at the hepatic venous end of the shunt tract in 40(bare stent group)and covered stent was implanted at the hepatic venous end of the shunt tract in 27(covered stent group).The average hospitalization days,incidence of major adverse events,shunt patency rate,percentage of no occurrence of hepatic encephalopathy,and survival rate were compared between the two groups.Results The patient's baseline data and lesion's characteristics between the two groups were comparable.No statistically significant differences in the shunt patency rate,percentage of no occurrence of hepatic encephalopathy,survival rate,average hospitalization days,and incidence of major adverse events existed between the two groups(all P>0.05).ConclusionIn treating portal hypertension with TIPS,the stents having diferent hepatic vein end morphology have the same clinical efficacy and safety.