Comparison of the efficacy transjugular intrahepatic portosystemic shunt and percutaneous transhepatic variceal embolization for cirrhosis with esophageal gastric varices bleeding
10.11958/20160136
- VernacularTitle:TIPS和PTVE治疗肝硬化食管胃底静脉曲张破裂出血的临床效果比较
- Author:
Dan YANG
;
Guoliang ZHANG
;
Fengmei WANG
;
Fen BIAN
;
Kefeng JIA
- Publication Type:Journal Article
- Keywords:
portasystemic shunt,transjugular intrahepatic;
esophageal and gastric varices;
hemorrhage;
liver cirrhosis;
hepatic encephalopathy;
percutaneous transhepatic variceal embolization;
rebleeding rate;
liver function
- From:
Tianjin Medical Journal
2016;44(5):529-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical effect of transjugular intrahepatic portosystemic shunt (TIPS) and percutaneous transhepatic variceal embolization (PTVE) on the treatment of cirrhosis with esophageal gastric varices bleeding. Methods The data of 61 patients of liver cirrhosis combined with esophageal gastric varices bleeding who underwent the interventional treatment were included in the retrospective analysis. Patients were divided into two groups, PTVE treatment group (n=42), and TIPS treatment group (n=19). The success rate of clinical treatment, the rebleeding rate, the alleviation of varicose veins, the incidence of hepatic encephalopathy, survival rate and liver function parameters were compared between two groups. Results Two groups of surgery were successful. The portal vein pressure decreased obviously in TIPS group. The rebleeding rate was higher in PTVE group (78.6%) than that in TIPS group (63.2%). The total alleviation rate of esophageal gastric varices was significantly lower in PTVE group (50.0%) than that in TIPS group (89.5%, P<0.05). The incidence rates of hepatic encephalopathy were 14.3% and 26.3% for PTVE group and TIPS group respectively. The two-year cumulative survival rates of PTVE group and TIPS group were 95.2% and 89.5% respectively, and there was no statistically significant difference between two groups. After surgery, the liver function parameters were not significantly different from those determined before the treatment in PTVE group. At 1 month and 3 months after TIPS, the liver functions were declined obviously. At 6 and 12 months after the treatment, the liver functions were not significantly different from those determined before the treatment in PTVE group. Conclusion The surgery of TIPS is safe and ideal interventional treatment for cirrhosis with esophageal gastric varices bleeding, which has the lower rebleeding rate, better esophageal gastric varices alleviation rate and long term less influence in liver function.
