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预防性横内肝移植系统分流的时间窗口可以延长到5天

Xiangjun Dong^1,2, Jiacheng Liu^1,2, Yaowei Bai^1,2

¹Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

|June 12, 2024

概括

在急性水出血中,用于预防性横内肝移植系统分流 (pTIPS) 的72小时窗口不是限制性的. 在72小时至5天之间接受pTIPS的肝硬化患者的临床结果与在72小时内接受治疗的患者相似.

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:

巴维诺七号共识建议在肝硬化中预防性跨内肝内移植系统分流 (pTIPS) 治疗急性水出血 (AVB).
对于pTIPS而言,已建立的72小时窗口可能过于狭窄,需要对后来的干预时间进行调查.

研究的目的:

根据干预时间:<72小时与72小时到5天相比,在患有AVB的肝患者中比较pTIPS的临床结果:<72小时.
在这个患者队列中确定死亡率和明显肝脑病变 (OHE) 的独立风险因素.

主要方法:

对63名患有AVB的肝硬化患者进行了回顾性研究,这些患者在2016年10月至2021年12月期间接受了pTIPS.
患者被分为两个组:<72小时 (n=32) 和72小时-5天 (n=31).
卡普兰-梅尔曲线被用来分析累计死亡,再出血,OHE和分流器功能障碍发生率的差异.

主要成果:

在<72h和72h-5d组之间,累计发生的死亡 (22.3%与19.9%),水再出血 (9.7%与17.8%),OHE (28.5%与23.9%) 或分流器功能障碍 (8.6%与17.4%) 没有显著差异.
萨科佩尼亚被确定为死亡率 (HR=11.268) 和OHE (HR=12.504) 的独立风险因素.

结论:

在72小时至5天窗口内接受pTIPS的AVB肝炎患者的临床结果与在72小时内接受治疗的患者相似.
延长pTIPS干预窗口超过72小时可能是一个可行的策略,而不会影响患者的治疗结果.
萨科佩尼亚是接受pTIPS的AVB患者不良结果的重要预测因素.

关键词:

有急性水出血的情况.预防性 TIPS 服务预后预后预测预测萨尔科佩尼亚是什么意思萨尔科佩尼亚时间窗口时间窗口.

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