Analysis of influencing factors of shunt dysfunction after transjugular intrahepatic portosystemic shunt in liver cirrhosis accompanied with portal vein thrombosis
10.3760/cma.j.cn501113-20200301-00079
- VernacularTitle:肝硬化伴门静脉血栓经颈静脉肝内门体分流术后分流道失功能的影响因素分析
- Author:
Xu LI
1
;
Hongliang WANG
;
Tanyang ZHOU
;
Shengqun CHEN
;
Chunhui NIE
;
Yuelin ZHANG
;
Ziniu YU
;
Guanhui ZHOU
;
Tongyin ZHU
;
Junhui SUN
Author Information
1. 浙江大学医学院附属第一医院肝胆胰介入中心，杭州 310003；嘉兴市第二医院放射科，嘉兴 314000
- Keywords:
Liver cirrhosis;
Portal vein thrombosis;
Transjugular intrahepatic portosystemic shunt;
Portal hypertension;
Shunt dysfunction
- From:
Chinese Journal of Hepatology
2020;28(9):742-746
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of shunt after transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis accompanied with portal vein thrombosis (PVT).Methods:Forty-four cases with liver cirrhosis accompanied with PVT who underwent TIPS treatment from January 2015 to May 2018 were retrospectively analyzed. Clinical baseline data of the patients were collected. Portal vein pressure gradient (PVPG) before and after the surgery was recorded. Shunt patency was observed at 3, 6, 12, 18 and 24 months after the surgery. The influencing factors were determined by univariate and multivariate analysis.Results:Transjugular intrahepatic portosystemic shunt was successfully established in all 44 cases. The postoperative PVPG was lower than preoperative ( P < 0.01). The shunt patency rate after TIPS in PVT was 18.2% ( n = 8). The cumulative shunt patency rates at 3, 6, 12, 18, and 24 months after surgery were 95.5%, 90.7%, 90.7%, 86.8% and 74.4%, respectively. Univariate analysis showed that diabetes history, platelet level and prothrombin time-international normalized ratio were associated with postoperative shunt dysfunction. Multivariate analysis showed that diabetes history ( P = 0.007, OR = 28.606) was an independent risk factor for postoperative shunt dysfunction. Conclusion:TIPS is a safe and feasible procedure, which can effectively reduce the portal pressure in liver cirrhosis accompanied with PVT. Diabetic patients have a higher risk of postoperative shunt dysfunction. Therefore, clinical intervention should be strengthened for high-risk patients.
