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德国住院患者的TIPS的使用和结果:全国性研究 (2007-2018)
Wenyi Gu1,2, Yasmin Zeleke2, Hannah Hortlik2
1Department of Internal Medicine B, University Hospital Muenster, Muenster, Germany.
Hepatology communications
|September 14, 2023
概括
跨内肝移植系统分流 (TIPS) 放置越来越多地用于肝硬化并发症. TIPS改善了炎和肝综合征的结果,但较高的肝脑病,感染和循环系统疾病增加了死亡风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 干预性放射学 干预性放射学
- 胃肠病学 胃肠病学
背景情况:
- 肝硬化患者的并发症正在增加.
- 门高血压是肝硬化并发症的主要驱动因素.
- 跨内肝移植系统分流 (TIPS) 放置是门高血压最有效的治疗方法.
研究的目的:
- 在一项德国全国性的研究中,分析TIPS安置在过去十年中的利用和影响.
- 评估TIPS在治疗肝硬化并发症方面的有效性.
主要方法:
- 在德国 (2007-2018) 用DRG系统对14598名TIPS插入患者的入院情况进行分析.
- 包括12877例住院病例,其中2万765例是肝硬化病例.
- 使用ICD-10-CM和OPS代码编码诊断和程序,专注于入院和住院死亡率.
主要成果:
- 在过去的十年中,TIPS的投资量显著增加.
- 与替代治疗相比,TIPS安置减少了严重出血,,肝综合征 (HRS) 的住院死亡率.
- 虽然22.6%的TIPS入院患者显示肝脑病变 (HE),但 TIPS的较低HE等级 (1-2) 的死亡率低于没有TIPS的死亡率.
结论:
- 全国数据证实,德国的TIPS使用量有所增加.
- 插入TIPS可以改善患者的治疗结果,特别是对于风和HRS,不管HE等级较低.
- 较高的HE等级,感染和循环系统疾病独立地与接受TIPS患者的住院死亡率增加有关.
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