[1]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(04):380-384.
 MA Kunpeng,LIANG Songnian,ZHONG Hongshan,et al.TIPS creation by using Viatorr stent-graft for the treatment of variceal gastrointestinal bleeding due to portal hypertension: evaluation of its clinical efficacy[J].journal interventional radiology,2020,29(04):380-384.
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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()

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

卷:
29
期数:
2020年04
页码:
380-384
栏目:
临床研究
出版日期:
2020-05-08

文章信息/Info

Title:
TIPS creation by using Viatorr stent-graft for the treatment of variceal gastrointestinal bleeding due to portal hypertension: evaluation of its clinical efficacy
作者:
马鹍鹏梁松年钟红珊罗婷张强健李东奇王子璇徐克
Author(s):
MA Kunpeng LIANG Songnian ZHONG Hongshan LUO Ting ZHANG Qiangjian LI Dongqi WANG Zixuan XU Ke.
Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province 110001, China
关键词:
【关键词】 经颈静脉肝内门体分流术Viatorr支架肝硬化门静脉高压症静脉曲张消化道出血
文献标志码:
A
摘要:
【摘要】 目的?评价应用Viatorr支架行经颈静脉肝内门体分流术(TIPS)术治疗门静脉高压性静脉曲张消化道出血的可行性、安全性和临床效果。方法?回顾性分析2015年10月至2018年11月收治的42例肝硬化门静脉高压性静脉曲张消化道出血患者临床资料,所有患者符合TIPS治疗指征,均接受Viatorr支架行TIPS术治疗。术中检测门静脉压力梯度(PPG)。术后1、3、6、12个月,之后每年随访超声或增强CT检查,评价分流道通畅情况,并通过电子病历、临床或电话随访患者肝功能、凝血4项、再出血、肝性脑病发生和生存时间。配对t检验分析术前、术后PPG、总胆红素、血清白蛋白和凝血酶原时间变化,Kaplan-Meier法分析分流道通畅率和生存率。结果?42例均成功施行TIPS术,技术成功率为100%。共植入直径8 mm Viatorr支架42枚。PPG均值由术前(26.85±6.00) mmHg(1 mmHg=0.133 kPa)降低为(11.62±4.54) mmHg(t=11.359,P<0.05),平均降低(55.63±16.77)%。与术前相比,术后3 d总胆红素浓度升高(P<0.05),血清白蛋白降低(P<0.05),凝血酶原时间延长(P<0.05)。术后1个月总胆红素、血清白蛋白和凝血酶原时间与术前水平差异均无统计学意义(P>0.05)。术后中位随访14.5(2~39)个月,再出血发生率为9.5%(4/42),其中1例接受分流道再通;肝性脑病发生率为19.1%(8/42)。术后1、2、3年分流道通畅率分别为91.9%、83.9%、77.4%,生存率分别为94.7%、89.4%、82.0%。肝硬化相关死亡率为9.5%(4/42),均于术后2~30个月死于终末期肝病伴多脏器功能衰竭。结论?Viatorr支架行TIPS术治疗肝硬化门静脉高压性静脉曲张消化道出血具有较高的技术成功率,术后分流道通畅率高,肝性脑病发生率低。

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备注/Memo

备注/Memo:
(收稿日期:2019-03-15)
(本文编辑:边?佶)
更新日期/Last Update: 2020-05-06