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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Combined TIPS with portal-azygous disconnection improved the long term clinical outcome in portal hypertension patients.
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Combined TIPS with portal-azygous disconnection improved the long term clinical outcome in portal hypertension patients.

机译：TIPS与门脉-断路结合的结合改善了门静脉高压症患者的长期临床结局。

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OBJECTIVE: The results of TIPS and the combined TIPS and portal-azygous disconnection for portal hypertension and variceal bleeding were evaluated. METHODS: 358 patients with portal hypertension were admitted to our clinical ward because of variceal bleeding. 263 patients underwent TIPS and 95 patients with combined TIPS and portal-azygous disconnection. Portal hemodynamics was evaluated by pressure measurements, venography and Doppler ultrasound before and 2 weeks after the procedure. The rates of shunt patency, rebleeding, encephalopathy and survival were observed during the follow-up period from 1 to 10 years. RESULTS: The portal pressure and HVPG were decreased significantly after TIPS. TIPS procedure was successfully performed in 97.50% patients. During 1 month after treatment, acute shunt occlusion occurred in 3.42% patients with TIPS and there were no occluded shunts in patients with combined TIPS and portal-azygous disconnection. Encephalopathy was observed in 36.50% patients with TIPS and 18.95% with combined TIPS and portal-azygous disconnection. Recurrent variceal bleeding was documented in 6.46% patients with TIPS and none of patients with combined TIPS and azygous portal disconnection. Thirty-three patients with TIPS and two patients with combined TIPS and portal-azygous disconnection died. During follow-up periods, the patency of shunts in patients with TIPS and patients combined TIPS and azygous portal disconnection was 68.47, 43.84 and 87.06, 57.65% in 12 and 24 months after operation, respectively. The rates of rebleeding, and encephalopathy in patients with TIPS and patients with combined TIPS and azygous portal disconnection were 17.95, 31.79 and 7.04, 16.47%, respectively. The survival rate in 1, 5, 10 years in patients with TIPS and patients combined TIPS and azygous portal disconnection was 87.68, 51.23, 39.90 and 94.12, 81.18, 76.47%. CONCLUSION: Combined TIPS and portal-azygous disconnection can improve the effect of TIPS for portal hypertension.
机译：目的：评价TIPS和TIPS联合门脉-门静脉切断术治疗门脉高压和静脉曲张破裂出血的结果。方法：358例门静脉高压症患者因静脉曲张破裂出血而入院。 263例患者接受了TIPS，95例患者合并了TIPS和门静脉合闸。术前和术后2周通过压力测量，静脉造影和多普勒超声评估门静脉血流动力学。在1至10年的随访期间，观察了分流通畅，再出血，脑病和生存率。结果：TIPS后门静脉压力和HVPG明显降低。在97.50％的患者中成功执行了TIPS程序。在治疗后的1个月内，TIPS患者中有3.42％发生了急性分流阻塞，而TIPS与门静脉合闸的合并患者中没有阻塞分流。在TIPS患者中有36.50％发生了脑病，在TIPS与门静脉合断术合并的患者中发现了18.95％。 TIPS患者中有6.46％发生静脉曲张破裂出血，而TIPS与门静脉曲张切断合并合并患者中无一例。 33例TIPS患者和2例合并TIPS和门静脉连接断开的患者死亡。在随访期间，手术后12个月和24个月内，TIPS患者以及合并TIPS和无动脉门断开的患者分流通畅率分别为68.47、43.84和87.06、57.65％。 TIPS患者以及合并TIPS和无动脉门断开的患者的再出血率和脑病率分别为17.95、31.79和7.04、16.47％。 TIPS患者以及合并TIPS和无动脉门断开的患者在1、5、10年的生存率分别为87.68、51.23、39.90和94.12、81.18、76.47％。结论：TIPS与门静脉断路结合可以提高TIPS治疗门脉高压的疗效。

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