[1]杨胜利,赖林强,宋晶晶,等.裸支架联合覆膜支架行经颈静脉肝内门体静脉分流术治疗门静脉高压症远期效果[J].介入放射学杂志,2024,33(03):295-299.
 YANG Shengli,LAI Linqiang,SONG Jingjing,et al.TIPS with bare stents and covered stents for the treatment of portal hypertension: analysis of its long-term efficacy[J].journal interventional radiology,2024,33(03):295-299.
点击复制

裸支架联合覆膜支架行经颈静脉肝内门体静脉分流术治疗门静脉高压症远期效果()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年03
页码:
295-299
栏目:
临床研究
出版日期:
2024-03-27

文章信息/Info

Title:
TIPS with bare stents and covered stents for the treatment of portal hypertension: analysis of its long-term efficacy
作者:
杨胜利 赖林强 宋晶晶 张登科 赵中伟 涂建飞 纪建松 鲍应军顾俊鹏 任伟新
Author(s):
YANG Shengli LAI Linqiang SONG Jingjing ZHANG Dengke ZHAO Zhongwei TU Jianfei JI Jiansong BAO Yingjun GU Junpeng REN Weixin.
Center of Interventional Diagnosis and Therapy, Lishui Municipal Central Hospital(Fifth Affiliated Hospital of Wenzhou Medical University), Lishui, Zhejiang Province 323000, China
关键词:
【关键词】 门静脉高压症 支架 远期疗效 生存率
文献标志码:
A
摘要:
【摘要】 目的 评价裸支架联合Fluency覆膜支架行经颈静脉肝内门体静脉分流术(TIPS)治疗门静脉高压症的远期效果和价值。方法 回顾性分析2012年8月至2017年12月因顽固性腹水或肝硬化门静脉高压所致门静脉高压食管胃底静脉曲张破裂出血(EGVB)在新疆医科大学第一附属医院和丽水市中心医院接受裸支架联合覆膜支架行TIPS治疗的29例患者临床资料。定期随访观察患者生存情况。采用Kaplan-Meier法分析患者术后分流道累积通畅率和累积生存率。结果 TIPS技术成功率为100%。门静脉压力由术前(40.21±3.24) cmH2O下降至术后(24.55±3.55) cmH2O(P<0.05)。随访5.1~10.5年。术后1、3、5、7年分流道一期累积通畅率分别为89.7%、75.9%、75.9%、52.5%,5、7、9、10年累积生存率分别为100%、66.9%、66.9%、33.4%。肝性脑病发生率为13.8%(4/29)。结论 采用裸支架联合Fluency覆膜支架行TIPS治疗门静脉高压症安全有效,远期分流道通畅率较高,肝性脑病发生率低。必要时可作为Viatorr支架替代应用。

参考文献/References:

[1] Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis[J]. N Engl J Med,2010,362:823-832.
[2] Tripathi D,Stanley AJ,Hayes PC,et al. Transjugular intrahepatic portosystemic stent-shunt in the management of portal hypertension[J]. Gut, 2020, 69: 1173-1192.
[3] Perarnau JM, Le Gouge A, Nicolas C, et al. Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial[J]. J Hepatol, 2014, 60: 962-968.
[4] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 实用肝脏病杂志, 2016, 19:I0001-I0016.
[5] 中国医师协会介入医师分会. 中国门静脉高压经颈静脉肝内门体分流术临床实践指南[J]. 中华肝脏病杂志, 2019, 27:582-593.
[6] Merli M, Salerno F, Riggio O, et al. Transjugular intrahepatic portosystemic shunt versus endoscopic sclerotherapy for the prevention of variceal bleeding in cirrhosis: a randomized multicenter trial. Gruppo Italiano Studio TIPS(G.I.S.T.)[J]. Hepatology, 1998, 27: 48-53.
[7] 陈斯良,赵剑波,陈 勇,等. 经颈静脉肝内门腔静脉分流术中覆膜支架与裸支架的不同放置方式对术后中长期疗效的影响[J]. 中华放射学杂志, 2016, 50:885-888.
[8] Kraglund F, Jepsen P, Amanavicius N, et al. Long-term effects and complications of the transjugular intrahepatic portosystemic shunt: a single-centre experience[J]. Scand J Gastroenterol, 2019, 54: 899-904.
[9] 胡 朋,陈斯良,罗泽龙,等. 采用裸支架联合覆膜支架建立经颈静脉肝内门体分流术的中远期疗效[J]. 中国介入影像与治疗学, 2016, 13:394-397.
[10] 马鹍鹏,梁松年,钟红珊,等. Viatorr支架行TIPS术治疗门静脉高压性静脉曲张消化道出血效果评估[J]. 介入放射学杂志, 2020, 29:380-384.
[11] 滕皋军,徐 克. TIPS再狭窄的研究现状和进展[J]. 介入放射学杂志, 2005, 14:87-91.
[12] 李松蔚,李迎春,闫 东,等. Fluency覆膜支架行TIPS术后支架狭窄原因分析[J]. 介入放射学杂志, 2015, 24:1047-1051.
[13] Wang Q, Lv Y, Bai M, et al. Eight millimetre covered TIPS does not compromise shunt function but reduces hepatic encephalopathy in preventing variceal rebleeding[J]. J Hepatol, 2017, 67: 508-516.
[14] Liu J, Meng J, Zhou C, et al. A new choice of stent for transjugular intrahepatic portosystemic shunt creation: viabahn ePTFE covered stent/bare metal stent combination[J]. J Interv Med, 2021, 4: 32-38.
[15] Shao H, Han X, Zhao J, et al. Status of transjugular intrahepatic portosystemic shunt for portal hypertension in China: a national survey analysis[J]. Port Hypertens Cirrhos, 2023, 2: 9–15.

相似文献/References:

[1]刘 娟,姚国恩,周华东,等. 心脏临时起搏器在颅外颈动脉支架置入术中的应用观察[J].介入放射学杂志,2012,(02):154.
 LIU Juan,YAO Guo-en,ZHOU Hua-dong,et al.Clinical application of transvenous temporary cardiac pacemaker in performing extra-cranial carotid angiography and stent implantation[J].journal interventional radiology,2012,(03):154.
[2]郑辉,郭富强.Rho/Rho激酶信号通路与支架内再狭窄的研究[J].介入放射学杂志,2012,(02):172.
 ZHENG Hui,GUO Fu-qiang..Studies on Rho/Rho-kinase signalling pathways and in-stent restenosis[J].journal interventional radiology,2012,(03):172.
[3]何仕诚,滕皋军,郭金和,等.自制Palmaz支架的动物实验研究[J].介入放射学杂志,2000,(03):174.
[4]金惠根,王肖龙,陆志刚,等.冠脉内支架在冠脉病变中的应用价值[J].介入放射学杂志,1999,(02):12.
[5]谢苏庆,许国铭.治疗门脉高压的新途径——经颈静脉肝内门体分流术[J].介入放射学杂志,1994,(02):116.
[6]陈云燕.TIPSS的并发症[J].介入放射学杂志,1994,(03):174.
[7]祖茂衡,徐浩,顾玉明,等.血管内支架放置治疗下腔静脉闭塞伴血栓形成[J].介入放射学杂志,1995,(04):195.
[8]王永杰,王洪明,王向阳,等.血管内支架置入术治疗下腔静脉阻塞[J].介入放射学杂志,1995,(04):198.
[9]吴永发,黄清海,杨鹏飞,等.Onyx联合支架辅助弹簧圈治疗复杂性颅内破裂动脉瘤[J].介入放射学杂志,2011,(04):261.
 WU Yong-fa,HUANG Qing-hai,YANG Peng-fei,et al.Onyx combined with coiling embolization for endovascular treatment of complex intracranial ruptured aneurysms[J].journal interventional radiology,2011,(03):261.
[10]林开勤,胡晓钢,何建荣,等.经腘动脉入路逆行治疗同侧股浅动脉近端狭窄和闭塞的临床应用[J].介入放射学杂志,2011,(12):953.
 LIN Kai-qin,HU Xiao-gang,HE Jian-rong,et al.Retrograde catheterization via politeal artery for the treatment of ipsilateral superficial femoral artery occlusive disease: its clinical application[J].journal interventional radiology,2011,(03):953.

备注/Memo

备注/Memo:
(收稿日期:2023-03-03)
(本文编辑:谷 珂)
更新日期/Last Update: 2024-03-27