经颈静脉肝内门体分流术治疗肝细胞癌：初步研究。

Trans-jugular intrahepatic portosystemic shunt in patients with hepatic cellular carcinoma: A preliminary study.

机构信息

Nursing Department, The Second Hospital of Shandong University; Interventional Oncology Institute, Shandong University, Jinan, Shandong Province, China.

Dean' s Office, Jinan Vocational College of Nursing, Jinan, Shandong Province, China.

出版信息

J Cancer Res Ther. 2021 Jul;17(3):784-789. doi: 10.4103/jcrt.jcrt_467_21.

DOI:10.4103/jcrt.jcrt_467_21

PMID:34269314

Abstract

PURPOSE

To analyze the effects of trans-jugular intrahepatic portosystemic shunt (TIPS) on portal hypertension and liver function in patients with hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

Thirteen patients with hemorrhage caused by portal hypertension and HCC who received TIPS and antitumor treatment were retrospectively analyzed. Trans-arterial chemoembolization, microwave ablation, target therapy, and immunetherapy or combined therapy were performed to treat HCC. Child-Pugh score was applied to estimate liver functions before and after TIPS. Shunting patency, overall survival (OS), and progression-free survival were analyzed.

RESULTS

The median age was 58 (interquartile range: 52.5-62.5) years. The ratio with ascites before and after TIPS was 84.6% (11/13) and 7.7% (1/13), with P < 0.001. The ratio with Child-Pugh A before and after TIPS were 61.5% (8/13) and 84.6% (11/13) respectively, with P = 0.179. Mean portal vein pressure before and after TIPS was 27.85 ± 7.02 mmHg and 16.23 ± 6.61 mmHg, respectively, with P = 0.001. Two-year shunting patency rate was 61.5%. Median OS was 29.8 ± 11.5 months (95% confidence interval [CI] 22.8-36.7), and median progression-free survival was 20.2 ± 13.2 months (95% CI 12.2-28.1).

CONCLUSION

TIPS could reduce ascites, down-regulate the Child-Pugh score, and give a chance for further anti-tumor therapy.

摘要

目的

分析经颈静脉肝内门体分流术（TIPS）对肝癌（HCC）合并门静脉高压患者门静脉高压和肝功能的影响。

材料与方法

回顾性分析 13 例因门静脉高压出血合并 HCC 而行 TIPS 并接受抗肿瘤治疗的患者。采用经动脉化疗栓塞、微波消融、靶向治疗、免疫治疗或联合治疗治疗 HCC。采用 Child-Pugh 评分评估 TIPS 前后的肝功能。分析分流通畅率、总生存期（OS）和无进展生存期。

结果

中位年龄为 58（四分位距：52.5-62.5）岁。TIPS 前后腹水的比例分别为 84.6%（11/13）和 7.7%（1/13），P<0.001。TIPS 前后 Child-Pugh A 的比例分别为 61.5%（8/13）和 84.6%（11/13），P=0.179。TIPS 前后门静脉压力分别为 27.85±7.02mmHg 和 16.23±6.61mmHg，P=0.001。2 年分流通畅率为 61.5%。中位 OS 为 29.8±11.5 个月（95%CI 22.8-36.7），中位无进展生存期为 20.2±13.2 个月（95%CI 12.2-28.1）。