Curative effect comparison of bare stent combined with covered stent TIPS in the treatment of portal hypertension and upper gastrointestinal bleeding
ZENG Jing-ke1 LAI Xiao-huan1 XIAO Shen-rong2 YE Jian-min1 WANG Shui-gen1 HUANG Chun-hua1
1. Department of Liver Diseases, the Fifth People′s Hospital of Ganzhou City, Jiangxi Province, Ganzhou 341000,China;
2. Department of Liver Diseases, People′s Hospital of Wan′an County, Jiangxi Province, Wan′an 343800, China
Abstract： Objective To explore the curative effect of bare stent combined with covered stent transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension and upper gastrointestinal bleeding (UGIB). Methods Sixty patients with portal hypertension and UGIB who were admitted to the Fifth People′s Hospital of Ganzhou City,Jiangxi Province from January 2019 to January 2020 were selected as the research objects and divided into the control group and the observation group according to the alternate grouping method, with 30 cases in each group. The control group was treated with conventional comprehensive treatment, and the observation group was treated with bare stent combined with covered stent TIPS. The portal vein parameters (portal pressure [PVP], portal vein flow rate [PVV]) before treatment and 24 hours of treatment, the effective rate of hemostasis within 24 hours, complications, shunt restenosis rate, recurrence bleeding rate and case fatality rate were compared between the two groups. Results At 24 hours of treatment, the PVP levels of the two groups were lower than those before treatment, PVV levels were higher than those before treatment, and the PVP of the observation group was lower than that of the control group, the PVV was higher than that of the control group, the differences were statistically significant (P＜0.05). The effective rate of hemostasis within 24 h of the observation group (96.67%) was higher than that of the control group (23.33%), and the difference was statistically significant (P＜0.05). There was no statistically significant difference in total incidence of complications between the two groups (P＞0.05). The shunt restenosis rate (3.33%) and recurrent bleeding rate (10.00%) in observation group were lower than those in control group (26.67%, 33.33%), and the differences were statistically significant (P＜0.05). There was no statistically significant difference in mortality between the two groups (P＞0.05). Conclusion Bare stent combined with covered stent TIPS has high hemostasis efficiency in the treatment of patients with portal hypertension and UGIB, and reduces portal pressure without increasing the risk of complications, long-term recurrence of bleeding, and low mortality.
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