PTFE 覆膜支架与裸支架在TIPSS 治疗门静脉高压症中的疗效比较
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任伟新, Email: rwx1031@163.com

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PTFE-covered stent versus bare stent in transjugular intrahepatic portosystemic stent shunt for portal hypertension
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    摘要:

    目的:比较聚四氟乙烯(PTFE)覆膜支架和裸支架在经颈静脉肝内门腔静脉支架分流术(TIPSS)治疗门静脉高压症中的临床疗效。 方法:52例门静脉高压症患者分别采用裸支架(裸支架组,32例)与覆膜支架(覆膜支架组,20例)行TIPSS治疗,比较两组患者术后分流道的通畅率、肝性脑病的发生率、门静脉压力变化、血液学检查结果及腹水缓解率。 结果:两组患者均成功施行TIPSS术,覆膜支架组术后随访(8.11±4.9)个月,裸支架组(8.34± 4.4)个月。随访6个月过程中两组通畅率差异无统计学意义(P>0.05),但随访12个月过程中,覆膜支架组通畅率高于裸支架组(P<0.05);两组患者术后门静脉压力均明显降低(均P<0.05),但两组间下降幅度差异无统计学意义(P>0.05);两组肝性脑病发生率差异无统计学意义(P>0.05);裸支架组术后白细胞的升高程度高于覆膜支架组(P<0.05),两组间其他血液学指标差异无统计学意义(均P>0.05);两组腹水缓解率差异无统计学以(P>0.05)。 结论:TIPSS治疗门静脉高压症中使用PTFE覆膜支架的远期分流道通畅率高于裸支架。

    Abstract:

    Objective: To compare the clinical efficacy of the use of PTFE-covered stent and bare stent in transjugular intrahepatic portosystemic stent shunt (TIPSS) for portal hypertension. Methods: Fifty-two patients with portal hypertension underwent TIPSS with PTFE-covered stent (covered stent group, 20 cases) or with bare stent (bare stent group, 32 cases). The shunt patency, changes in portal venous pressure, hematological examination results and improvement of ascites between the two groups were compared. Results: TIPSS was successfully performed in all patients of the two groups, and length of postoperative follow-up in covered stent group was (8.11±4.9) months and in bare stent group was (8.34±4.4) months. The shunt patency rate showed no statistical difference between the two groups during 6-month follow-up period (P>0.05), but it was significantly higher in covered stent group than that in bare stent group during the 12-month follow-up period (P<0.05). The postoperative portal venous pressures in both groups were significantly decreased compared with their preoperative levels (both P<0.05), but the decreasing amplitudes between the two groups showed no statistical difference (P>0.05). No statistical difference was noted in the incidence of hepatic encephalopathy between the two groups (P>0.05). The degree of white blood cell increase in bare stent group was significantly higher than that in covered stent group (P>0.05), but no statistical difference was seen in other hematological parameters (all P>0.05). The improvement of ascites of the two groups had no statistical difference (P>0.05). Conclusion: The long-term shunt patency of TIPSS for portal hypertension using PTFE-covered stent is higher than that of using bare stent.

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鲍应军|顾俊鹏|纪卫政|张海潇|朱帝文|任伟新. PTFE 覆膜支架与裸支架在TIPSS 治疗门静脉高压症中的疗效比较[J].中国普通外科杂志,2014,23(1):81-86.
DOI:10.7659/j. issn.1005-6947.2014.01.016

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  • 收稿日期:2013-08-18
  • 最后修改日期:2013-12-03
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  • 在线发布日期: 2014-01-15