Effects of Fluency stent used in transjugular intrahepatic portosystemic shunt on hepatic function,renal function and survival rate / 中华放射学杂志

ABSTRACT

Objective To investigate the efficiency of transjugular intrahepatic portosystemic shunt (TIPS) with Fluency stent in improving the hepatic and renal function and survival rate in patients with decompensated cirrhosis.Methods The decompensated cirrhosis patients who were treated in our hospital from May 2008 to September 2011 were retrospectively analyzed.One group of patients (n =48) undergoing TIPS was randomly selected as treatment group,while another group of patients (n =48) treated by medicine and therapeutic endoscope was randomly chosen as control group.Clinical data and fellow-up data were retrospectively reviewed.There was no significant deviation in baseline characteristics (age,gender composition,etiology,renal function,hepatic function et al) among all the patients before the operations; The laboratory results of hepatic and renal function in 2 groups before and after operation (1 week,20 days,3 months,6 months,1 year,2 years,3 years) were recorded and compared with independent samples t-test or Wilcoxon rank sum test.The survival rates of two groups in 3 years were analyzed using Kaplan-Meier survival curve and compared with Chi-square test.Results Three years after the operation,there were significant differences between the treatment group and the control group in AST(70.8 vs.108.7 U/L,Z =-2.958,P ＜ 0.05) and TBIL (51.2 vs.76.2 μmol/L,Z =-2.004,P ＜ 0.05).The Cr value of the 3rd year after the treatment were (9928.2 ± 2363.8) in the the control group and (7742.1 ± 2845.6) μmol/L in the treatment group(t =-2.074,P ＜ 0.05).BUN of the 1st,2nd and 3rd years after the treatment were (2.0 ± 1.1),(2.3 ± 1.5),(2.5 ± 1.3) mmol/L in the treatment group,while it was (2.6 ± 1.1),(3.8 ±1.2),(5.4 ± 1.1)mmol/L in the control group.There was significant difference between the 2 groups (t =-2.222,-3.940 and-6.110,P ＜ 0.05).Comparing the survival rate in the 2 groups with Kaplan-Meier survival curve,the 3 year survival rate in the treatment group was 46.2％,while in the control group it was only 30.0％ (x2 =6.341,P ＜ 0.05).Conclusions Compared with medicine therapy and therapeutic endoscopy,TIPS with Fluency stent may improve the hepatic function,renal function and survival rate in liver cirrhosis patients.It is a safe and effective therapy choice for patients with decompensated cirrhosis.