在接受手术的肝硬化患者中,手术前的TIPS和住院死亡率
Felix Piecha1, Joscha Vonderlin2, Friederike Frühhaber1
1I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
JHEP reports : innovation in hepatology
|December 11, 2023
概括
在肝硬化患者中,手术前的跨内肝移植系统分流 (TIPS) 放置可能会降低手术后的室内死亡率和肝移植率. 这一发现表明,TIPS可以改善选择性肝硬化患者的外科治疗结果,特别是患有瘤的患者.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 手术瘤学手术瘤学
- 干预性放射学 干预性放射学
背景情况:
- 肝硬化显著增加了外科手术发病率和死亡率.
- 门高血压和手术类型是影响术后结果的关键因素.
研究的目的:
- 为了调查手术前的横性肝脏内移植系统分流 (TIPS) 放置是否会降低室内死亡率或在接受手术的肝硬化患者中需要肝移植 (LT).
主要方法:
- 在TIPS安置后3个月内接受手术的64名肝硬化患者和2010-2020年131名对照患者 (没有TIPS的手术) 的回顾性分析.
- 操作被分为低风险或高风险.
- 多变量考克斯回归分析了影响室内死亡率/LT的因素,包括术前TIPS,手术风险,MELD得分和.
主要成果:
- 与对照组相比,TIPS队列的内部死亡率/LT (19%vs. 40%) 的发生率较低.
- 这种生存益处在低风险 (0% vs. 16%) 和高风险手术亚组中都被观察到.
- 手术前的TIPS安置独立地与手术后的室内死亡率/LT (HR 0.44) 的降低有关.
结论:
- 在手术前的TIPS安置可能与某些肝硬化患者的手术后室内死亡率降低有关.
- 建议在接受手术的肝硬化患者,特别是患有瘤的患者考虑进行手术前的TIPS.
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