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肝硬化伴自发性门体分流相关复发性或持续性肝性脑病患者的介入栓塞治疗:一项前瞻性、非随机对照研究方案。

Interventional embolisation for patients with cirrhosis and recurrent or persistent hepatic encephalopathy related to spontaneous portosystemic shunts: protocol for a prospective, non-randomised controlled study.

机构信息

Department of Interventional Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China.

Department of Hepatopancreatobiliary Surgery, Clinical Oncology School of Fujian Medical University, Fuzhou, Fujian, China.

出版信息

BMJ Open. 2024 Feb 12;14(2):e081194. doi: 10.1136/bmjopen-2023-081194.

Abstract

INTRODUCTION

The presence of spontaneous portosystemic shunts (SPSS) has been identified to be associated with hepatic encephalopathy (HE) in patients with cirrhosis. Nevertheless, the role of interventional embolisation in managing such patients remains poorly defined. Consequently, this prospective controlled study aims to assess the efficacy and safety of interventional embolisation as a therapeutic approach for patients with cirrhosis and recurrent or persistent HE related to SPSS.

METHODS AND ANALYSIS

Cirrhotic patients diagnosed with recurrent or persistent HE associated with SPSS will be recruited for this study, and assigned to either the interventional embolisation group or the standard medical treatment group. The efficacy endpoints encompass the evaluation of postoperative alleviation of HE symptoms and the incidence of overt HE recurrence during the follow-up period, as well as the duration and frequency of hospitalisations for HE, alterations in liver function and volume, and overall survival. The safety endpoints encompass both immediate and long-term postoperative complications.

ETHICS AND DISSEMINATION

This study will be conducted in strict adherence to the principles of good clinical practice and the guidelines outlined in the Declaration of Helsinki. Ethical approval for the trial has been obtained from the Ethics Committee of Mengchao Hepatobiliary Hospital of Fujian Medical University (2023_013_02). Written informed consent will be obtained from all the participants by the treating physician for each patient prior to their enrolment. The documented informed consent forms will be retained as part of the clinical trial records for future reference. The study findings will be disseminated through publication in peer-reviewed journals and will be presented at international conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2300072189.

摘要

简介

自发性门体分流(SPSS)的存在已被确定与肝硬化患者的肝性脑病(HE)有关。然而,介入栓塞在治疗此类患者中的作用仍未得到明确界定。因此,本前瞻性对照研究旨在评估介入栓塞作为治疗肝硬化伴复发性或持续性与 SPSS 相关的 HE 患者的疗效和安全性。

方法与分析

本研究将招募诊断为复发性或持续性与 SPSS 相关的 HE 的肝硬化患者,并将其分配到介入栓塞组或标准药物治疗组。疗效终点包括术后 HE 症状缓解的评估和随访期间显性 HE 复发的发生率,以及 HE 住院的持续时间和频率、肝功能和体积的变化以及总生存率。安全性终点包括术后即刻和长期并发症。

伦理与传播

本研究将严格遵循良好临床实践原则和赫尔辛基宣言中的指南进行。该试验已获得福建医科大学孟超肝胆医院伦理委员会的批准(2023_013_02)。每位患者的治疗医生将在入组前获得所有参与者的书面知情同意书。记录的知情同意书将作为临床试验记录的一部分保留,以备将来参考。研究结果将通过发表在同行评议的期刊上进行传播,并将在国际会议上展示。

试验注册号

ChiCTR2300072189。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b717/10862332/c5ddb2d7b5a4/bmjopen-2023-081194f01.jpg

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