裸金属支架与PTFE-覆膜支架行TIPSS治疗门静脉高压症患者临床疗效对比研究

doi:10.3969/j.issn.1672-5069.2017.02.011

实用肝脏病杂志 ›› 2017, Vol. 20 ›› Issue (2): 171-174.doi: 10.3969/j.issn.1672-5069.2017.02.011

裸金属支架与PTFE-覆膜支架行TIPSS治疗门静脉高压症患者临床疗效对比研究

周筱燕，高娜，周岩芬

710003 西安市陕西省中医医院心血管病介入科

收稿日期:2016-09-07 出版日期:2017-04-10 发布日期:2017-06-07
通讯作者: 周岩芬，E-mail：zhouyanfen1978@126.com
作者简介:周筱燕，女，36岁，大学本科，主治医师。研究方向：肝硬化消化道大出血的防治。E-mail：zhouxiaoyan1980812@126.com

Comparison of technical and clinical efficacy of bare metal stent and PTFE-stentgraft of TIPSS in the treatment of patients with portal hypertension

Zhou Xiaoyan，Gao Na，Zhou Yanfen.

Department of Cardiovascular Disease，Chinese Medicine Hospital，Xi’an，710003，Shaanxi Province

Received:2016-09-07 Online:2017-04-10 Published:2017-06-07

摘要/Abstract

摘要： 目的使用裸金属支架（BMS）和聚四氟乙烯（PTFE）覆膜支架行经颈静脉肝内门腔静脉支架分流术（TIPSS）治疗门静脉高压症患者临床疗效和技术设备成本对比分析。方法 2010年5月～2015年6月对163例门静脉高压症患者行TIPSS术，患者平均年龄为（56±12）岁，女性占32.9 %。其中接受BMS支架80例，接受覆膜支架83例。结果本组技术成功率为97.5%，术后门体梯度压从（16.1±4.8） mmHg下降至（5.1±2.1） mmHg；两组技术成功率和门体梯度压降无显著性差异；Kaplan-Meier分析显示，两组14 d、6 m和2 a一期支架通畅率存在显著性差别，其中PTFE-覆膜支架组通畅率高；两组1 a生存率和肝性脑病发生率无显著性差异；金属支架和覆膜支架总成本分别为66570元和70455元。结论 TIPSS术是一种安全、有效的治疗门静脉高压症的方法。裸金属支架和PTFE-覆膜支架均具有良好的技术和临床效果，并发症发生率低。

关键词: 门静脉高压症, 经颈静脉肝内门腔静脉支架分流术, 裸金属支架, PTFE-覆膜支架

Abstract: Objective To compare the technical and clinical efficacy of bare metal stent（BMS） and polytetrafluoroethylene（PTFE）-stentgraft of transjugular intrahepatic portosystemic shunt（TIPSS） in treatment of patients with portal hypertension（PH）.Methods 163 patients（56±12 ys，32.9 % females） with PH receiving TIPSS were recuited in this study，and 80 patients received BMS and 83 received PTFE-stentgraft.Results The technical success rate was 97.5% due to four unsuccessful interventions. The portosystemic gradient decreased from （16.1±4.8） mmHg to（5.1±2.1） mmHg in the successful series. There was no significant differences as respect to technical success rate and portosystemic gradient decrease between the two groups；Kaplan-Meier analysis yielded significant differences in primary patency after 14 days，6 months and 2 years thereafter in favour of the stentgraft；Both groups showed good clinical results without significant difference in 1-year survival and hepatic encephalopathy occurrence；Costs to establish TIPSS and maintain 2-year follow-up for constant patency were 66570 yuan in BMS group and 70455 yuan in PTFE-stentgraft.Conclusion TIPSS is a safe and effective procedure to manage portal hypertension. Both BMS stent and PTFE-stentgraft enable good technical and clinical outcomes with low complication rate，while the primary patency rate is clearly in favour of the stentgraft with a relative high costs.

Key words: Portal hypertension, Transjugular intrahepatic portosystemic shunt, Bare metal stent, polytetrafluoroethylene-stentgraft

周筱燕，高娜，周岩芬. 裸金属支架与PTFE-覆膜支架行TIPSS治疗门静脉高压症患者临床疗效对比研究[J]. 实用肝脏病杂志, 2017, 20(2): 171-174.

Zhou Xiaoyan，Gao Na，Zhou Yanfen.. Comparison of technical and clinical efficacy of bare metal stent and PTFE-stentgraft of TIPSS in the treatment of patients with portal hypertension[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(2): 171-174.

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裸金属支架与PTFE-覆膜支架行TIPSS治疗门静脉高压症患者临床疗效对比研究

Comparison of technical and clinical efficacy of bare metal stent and PTFE-stentgraft of TIPSS in the treatment of patients with portal hypertension

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