Transjugular intrahepatic portosystemic shunt for liver cirrhosis with severe portal thrombosis: survival outcome and its predictors

Zhengguo XU; Yongbing ZHAO; En LIU; Zhen YANG; Shiming YANG

doi:10.16016/j.1000-5404.201809054

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Transjugular intrahepatic portosystemic shunt for liver cirrhosis with severe portal thrombosis: survival outcome and its predictors

Clinical Medicine | 更新时间：2026-01-09

- Transjugular intrahepatic portosystemic shunt for liver cirrhosis with severe portal thrombosis: survival outcome and its predictors
- Journal of Third Military Medical University Vol. 40, Issue 23, Pages: 2204-2210，封三(2018)
- 作者机构：
  
  400037 重庆, 陆军军医大学(第三军医大学)第二附属医院消化内科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201809054
  CLC： R543.6;R575.2;R615
- Received：07 September 2018，
  
  Revised：2018-09-26，
  
  Published：15 December 2018
- 稿件说明：
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Zhengguo XU, Yongbing ZHAO, En LIU, et al. Transjugular intrahepatic portosystemic shunt for liver cirrhosis with severe portal thrombosis: survival outcome and its predictors[J]. Journal of Third Military Medical University, 2018, 40(23): 2204-2210，封三.
DOI：

Zhengguo XU, Yongbing ZHAO, En LIU, et al. Transjugular intrahepatic portosystemic shunt for liver cirrhosis with severe portal thrombosis: survival outcome and its predictors[J]. Journal of Third Military Medical University, 2018, 40(23): 2204-2210，封三. DOI： 10.16016/j.1000-5404.201809054.

摘要

目的

分析经颈静脉肝内门体分流术(transjugular intrahepatic portosystemic shunt

TIPS)用于治疗肝硬化合并严重门静脉血栓患者(portal vein thrombosis

PVT)的数据

了解其对生存的影响。

方法

回顾性分析2013年1月至2017年10月肝硬化合并门静脉系统严重非肿瘤性血栓行TIPS治疗的患者共44例

观察短期疗效(6个月)和长期疗效(1~3年)

同时通过经验总结及统计学分析得出生存预测因子和生存影响结局。

结果

44例患者TIPS治疗成功37例

手术成功率84%

术中无严重并发症

44例患者随访时间长达36个月

中位随访时间24个月。TIPS治疗成功组

大部分PVT再通

支架功能障碍3例

短期内(6个月)肝功有好转

2例死于肝癌

2例死于肝功能衰竭。TIPS失败组7例

门静脉血栓均无明显缓解

4例复发出血

其中2例死亡。统计分析得出:血管再通是生存的唯一预测因子

同时TIPS成功组生存率较失败组高。

结论

TIPS用于肝硬化合并严重门静脉血栓患者

使血管再通后能显著提高其生存率。

Abstract

Objective

To analyze the outcomes of patients with liver cirrhosis complicated by severe portal vein thrombosis (PVT) receiving transjugular intrahepatic portosystemic shunt (TIPS) and identify the predictors for the patients' survival.

Methods

We retrospectively analyzed the clinical data of 44 patients with liver cirrhosis complicated by severe non-neoplastic PVT undergoing TIPS between January

2013 and October

2017 to assess the short-term (6 months) and long-term (1~3 years) treatment efficacy. The survival outcomes of the patients and the predictors for the patient survival were analyzed.

Results

Among the 44 patients

TIPS was successfully completed in 37 patients (84%) without serious complications. The longest follow-up time of the patients was 36 months

and the median follow-up time was 24 months. In cases with successful TIPS

most of the PVT was revascularized

and stent dysfunction occurred in 3 cases. Within 6 months after the surgery

liver function was improved in most of the cases; 2 patients died due to liver cancer

and 2 due to liver failure. In the 7 cases with failed TIPS

no significant relief of portal vein thrombosis occurred after the surgery; 4 patients experienced recurrent bleeding

and 2 of them died. Statistical analysis showed that revascularization was the only predictor of patient survival

and the survival rate was higher in cases with successful TIPS than in cases with failed TIPS.

Conclusion

In patients with liver cirrhosis complicated by severe PVT

TIPS can significantly improve the survival rate after revascularization. Our results support the application of TIPS in such patients to improve their survival outcomes.

关键词

Keywords

references

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