Transjugular intrahepatic portosystemic shunt for hepatic sinusoidal obstruction syndrome caused by Gynura segetum:analysis of the mid-to-long-term survival
10.3969/j.issn.1008-794X.2025.02.012
- VernacularTitle:TIPS治疗土三七致肝窦阻塞综合征中长期生存分析
- Author:
Yulin WU
1
;
Changlong HOU
;
Baizhu XIONG
;
Lei ZHOU
;
Yipeng FEI
;
Yiran ZHOU
Author Information
1. 233030 安徽蚌埠 蚌埠医科大学研究生院
- Keywords:
hepatic sinusoidal obstruction syndrome;
transjugular intrahepatic portosystemic shunt;
gynura segetum;
survival rate
- From:
Journal of Interventional Radiology
2025;34(2):180-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of transjugular intrahepatic portosystemic shunt(TIPS)in treating patients with hepatic sinusoidal obstruction syndrome(HSOS)caused by gynura segetum,and to analyze the mid-to-long-term survival.Methods The clinical data of 44 patients with HSOS caused by gynura segetum,who were admitted to the First Affiliated Hospital of University of Science and Technology of China from April 2016 to September 2022 to receive TIPS treatment,were retrospectively analyzed.The preoperative and postoperative liver and kidney functions,ascites,and portal vein pressure were compared.Ultrasonography examination was performed to check the patency of stent and the thickness of ascites,the postoperative complications were recorded.Kaplan-Meier curve was used to calculate the cumulative survival so as to evaluate the survival of patients.Results Based on the severity of the illness,the 44 patients were divided into mild group(n=5),moderate group(n=13),severe group(n=19)and very severe group(n=7).Successful TIPS operation was achieved in all the patients,with a surgical success rate of 100％.No serious complications occurred.After TIPS,the incidence of hepatic encephalopathy(HE)was 20.5％(9/44).The portal pressure decreased from preoperative(42.00±0.91)cm H2 O to postoperative(18.27±0.67)cm H2O,the difference was statistically significant(P＜0.001).The postoperative blood creatinine,aminotransferase,total bilirubin and Child-Pugh score were decreased when compared with their preoperative values,while the albumin level was increased when compared with its preoperative value,the differences were statistically significant(all P＜0.05).The postoperative one-year and 5-year cumulative survival rates were 90.9％and 88.6％respectively.The 1-,3-,6-and 12-month survival rates in mild group were all 100％,in moderate group were 100.0％,100.0％,92.3％and 92.3％respectively,in severe group were 94.7％,94.7％,94.7％and 89.5％respectively,and in very severe group were 85.7％,71.4％,71.4％and 71.4％respectively.Conclusion For the treatment of HSOS caused by gynura segetum,TIPS can significantly improve the patient's ascites with low overall complication rate and high mid-to-long-term survival rate.
