| Objective:A comparative study was conducted on the clinical efficacy of TIPS in the treatment of portal hypertension due to cirrhosis using Viatorr stent and fluid-covered stent combined with naked stent,to explore the safety of the two types of stents,as well as postoperative complications and survival of patientsMethods:A retrospective analysis was conducted to collect the clinical data of 114 patients with cirrhosis portal hypertension treated with Viatorr stents or combination stents in our hospital from January 2014 to September 2018,including the Viatorr stents group(V group,n=70 cases)and combination stents group(Z group,nude stents+Fluency coated stents,n=44 cases).Postoperative follow-up was conducted to observe blood biochemical indicators,shunt patency,hepatic encephalopathy,ascites,portal vein thrombosis and survival.The measurement data were compared by t test and the counting data were tested by ?2 test.Results:The 114 patients were followed up for 2?36 months,with a median follow-up of 29 months,during which the mortality rate was 6.1%.Portal vein pressure in V group decreased from preoperative(33.44±7.65)mmHg to postoperative(23.39±6.34)mmHg,and in Z group from preoperative(27.59±5.63)mmHg to postoperative(18.02±4.97)mmHg,with statistically significant differences(P<0.05).The cumulative patency rates of group V and group Z were 92.9%and 63.6%,with statistically significant differences(P<0.05).There was no statistically significant difference in patency rate between group V and group Z at 1 year after surgery(P>,0.05),while there was a statistically significant difference in patency rate at 2?3 years after surgery(all P<0.05).The cumulative incidence of HE in group V was 25.7%and group Z was 22.7%,respectively,with no statistically significant difference(P>,0.05).After TIPS,ascites decreased or disappeared in 65 patients,with no effect in 23 patients.The effective rate of ascites treatment was 73.56%.After TIPS,27 patients with portal vein thrombosis were recanalized or significantly reduced,and the effective rate for treatment of portal vein thrombosis was 93.1%.There was no significant difference in the effective rate of ascites and portal vein thrombosis between the two groups after TIPS(P>.05).The postoperative survival rates of the Viatorr stent group and the combined stent group were 92.9%and 94.5%,respectively,with statistically significant differences(P<0.05).Conclusion(s):1.TIPS application of Viatorr stent or combination of stents in the treatment of portal hypertension in cirrhosis is a safe and effective treatment.2.TIPS surgery using Viatorr stents or combined stents can significantly reduce portal vein pressure,relieve clinical symptoms caused by portal hypertension,and have a low incidence of postoperative complications.3.Compared with combined stents,TIPS Viatorr stents showed similar clinical efficacy in 1 year after surgery.Compared with combined stents,TIPS Viatorr stents had a higher bypass patency rate in 2 to 3 years after surgery and did not significantly increase the incidence of postoperative hepatic encephalopathy. |
PDF Full Text Request