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已经存在的肝脏脑病变:真的是选择性 TIPS 的禁忌吗?
Pooya Torkian1, Stephanie Wallace2, Nicholas Lim3
1Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA. Ptorkian@umn.edu.
Cardiovascular and interventional radiology
|October 5, 2023
概括
经过关节内肝脏移植系统分流 (TIPS) 放置之前的肝脏脑病史 (HE) 并没有预测在术后三个月内发生HE. 医院住院和生存率等结果在以前有和没有HE的患者之间是相似的.
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:
- 肝脏脑病 (HE) 是肝脏疾病的常见并发症.
- 跨内肝移植系统分流 (TIPS) 是一种用于管理门高血压并发症的程序.
- 预先存在的HE对TIPS后的HE发展的影响尚未完全理解.
研究的目的:
- 评估前转肠内肝脏系统外送 (TIPS) 肝脏脑病变 (HE) 对TIPS后HE的发展的影响.
- 确定TIPS后高等教育发展的预测因素.
- 为了比较患有和没有TIPS前患者的临床结果,HE.
主要方法:
- 回顾性,单中心的观察性研究.
- 包括326名在2005年1月至2020年5月期间成功接受TIPS安置的患者.
- 在患有和没有TIPS前患者之间比较临床结果,包括HE发展,住院和存活率.
主要成果:
- 48.8%的患者有TIPS前的病史.
- 没有TIPS前HE的患者更有可能在TIPS后发展HE (81.4%vs67.3%,p=0.001).
- 在TIPS前的HE并不是在TIPS后3个月内在逻辑回归 (HR1.16,p=0.529) 上的HE发展的显著预测因素.
- 然而,在TIPS前的HE在随访期间的任何时候都能预测HE的发展 (p=0.002).
- 两组之间没有观察到HE发育,HE入院,3个月存活率或整体存活率的显著差异 (p>0.05).
结论:
- 预先TIPS HE没有预测TIPS安置后3个月内HE的发展.
- 临床结果,包括住院和存活率,在TIPS前和没有TIPS前的患者中是相似的.
- 可能需要进一步的研究来了解前TIPS HE对TIPS后结果的长期影响.
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