The impacts of transjugular intrahepatic portosystemic shunt on the portal vein diameter and long-term outcome of liver cirrhotic patients with portal hypertension
Objective To investigate the impacts of transjugular intrahepatic portosystemic shunt(TIPS)on portal vein diameter(PVD)and long-term outcome of patients with liver cirrhosis and portal hypertension(PHT).Methods A total of 100 patients with liver cirrhosis and PHT admitted from January 2017 to January 2020 were randomly grouped into a control group(50 cases,treated with pericardial revascularization)and a study group(50 cases,treated with TIPS)using a random number table method.The clinical data of all patients were collected and the liver hemodynamics,liver function,and long-term efficacy of the treatments in both groups of patients were compared.Results One day before surgery,there were no obvious differences in PVD,portal venous blood flow(PVF),splenic venous inner diameter(SVD),splenic venous blood flow(SVF),portal venous flow velocity(PVV),splenic venous flow velocity(SVV),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBIL)between the two groups(P＞0.05).At 7d after surgery,The PVD[(1.15±0.22)cm vs(1.53±0.32)cm],PVF[(774.45±101.28)mL vs(845.33±120.39)mL],SVD[(1.17±0.21)cm vs(1.32±0.27)cm],SVF[(304.47±63.38)mL vs(400.01±74.12)mL],ALT[(38.45±8.61)U/L vs(50.26±10.05)U/L],AST[(39.18±8.97)U/L vs(48.51±10.13)U/L],and TBil[(28.19±6.08)μmol/L vs(39.53±8.96)μmol/L]were decreased and improved more in the study group when compared with those in the control group(P＜0.05),whereas PVV[(45.69±9.98)cm/s vs(30.08±6.57)cm/s]and SVV[(24.76±6.02)cm/s vs(18.96±4.04)cm/s]were increased(P＜0.05).The survival rate of PHT patients with liver cirrhosis in both groups decreased with the increase of postoperative time,and the survival rate in the study group was obviously higher than that in the control group in 3 years after surgery(P＜0.05),moreover,the total incidence of adverse events in the study group was lower than that in the control group in three years after surgery,however,there was no obvious difference between the two groups(P＞0.05).Conclusion TIPS is effective in the treatment of PHT in patients with liver cirrhosis,and may obviously improve liver hemodynamics and liver function in patients with liver cirrhosis and PHT,with a good long-term effect on the patients.
Transjugular intrahepatic portosystemic shuntPericardial vascular disconnectionLiver cirrhosis with portal hypertensionDiameter of portal veinLong term efficacy
万方数据
维普
