Clinical study on prevention of upper gastrointestinal bleeding by transjugular intrahepatic portosystemic shunt
Objective To analyze the clinical effect of transjugular intrahepatic portosystemic shunt(TIPS)in preventing upper gastrointestinal bleeding.Methods A total of 120 patients with acute upper gastrointestinal bleeding admitted to the Second Affiliated Hospital of Xingtai Medical College from February 2021 to February 2023 were selected and randomly divided into ligation group(n=60)and TIPS group(n=60).The two groups were treated with endoscopic variceal ligation and TIPS respectively.The changes of portal pressure gradient,blood routine,blood flow and liver function were compared between the two groups before and after operation,and the patients were followed up for 12 months to record the incidence of cumulative rebleeding.Results The pressure gradient of portal vein decreased after operation in both groups.The portal vein pressure gradient,portal vein blood flow and splenic vein blood flow in TIPS group were lower than those in ligation group(P<0.05).Platelet,hemoglobin and red blood cell in the two groups were all higher than those before operation on the 3rd day after operation(P<0.05).At the same time,there was no statistical difference in blood routine indexes between the two groups(P>0.05).The levels of total bilirubin,alanine transaminase and aspartate transaminase in the two groups decreased on the 3rd day after operation,while those in the TIPS group were higher than those in the control group(P<0.05).The incidence of cumulative rebleeding in ligation group was 21.67%at 12 months after operation,which was higher than 8.33%in TIPS group(P<0.05).Conclusion Both TIPS and endoscopic ligation can achieve good hemostasis effect for upper gastrointestinal bleeding.TIPS is more effective in improving portal vein pressure gradient and blood flow and preventing rebleeding,but it has certain influence on the recovery of liver function.
万方数据
维普
