目的:比较Viatorr支架与覆膜支架联合裸支架在经颈静脉肝内门体静脉分流术（transjugular intrahepatic portosystemic shunt,TIPS）治疗门静脉高压症病人中,分流道通畅率及肝性脑发病率。方法:2014年5月至2017年9月,本中心收治的肝硬化门静脉高压接受TIPS治疗的病人中,使用Viatorr支架46例,覆膜支架联合裸支架79例。对手术前后门静脉压力的变化、术后分流道通畅率及肝性脑病发病率进行比较。结果:Viatorr支架与覆膜支架联合裸支架两组手术前、后门静脉压力的变化差异无统计学意义。随访12个月,Viatorr支架组分流道通畅率97.8%,覆膜支架联合裸支架组分流道通畅率83.5%。Viatorr支架组肝性脑病发病率4.3%,覆膜支架联合裸支架组肝性脑病发病率11.4%。结论:TIPS使用Viatorr支架,可明显提高分流道近期通畅率,在肝性脑病发病率方面两者差异无统计学意义。
Objective To compare shunt patency and hepatic encephalopathy rates following transjugular intrahepatic portosystemic shunt (TIPS) creation between Viatorr and covered stent combined with bare(metal) stent as combined stent. Methods From May 2014 to September 2017, the patients with cirrhosis and portal hypertension in our center had TIPS creation including 46 cases in Viatorr stent group and 79 cases in covered stent combined with bare(metal) stent. Portal venous pressure before and after TIPS creation, shunt patency and hepatic encephalopathy rates were compared between two groups. Results There was no significant difference in portal venous pressure before and after TIPS creation between Viatorr stent group and covered stent combined with bare(metal) stent. After 12 months of follow-up, patency rate was 97.8% in Viatorr stent group and 83.5% in covered stent combined with bare(metal) stent. Hepatic encephalopathy rate was 4.3% in Viatorr stent group and 11.4% in covered stent combined with bare(metal) stent. Conclusions TIPS creation with Viatorr stent improves short-term shunt patency rate. However, there was no statistical difference in hepatic encephalopathy rate between use Viatorr stent and combined stent graft.
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