Jiang Xinghe, Ma Xuan, Tian Shuni, Peng Lijun
School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China.
Department of Gastroenterology, Linyi People's Hospital Affiliated to Shandong Second Medical University, Linyi, Shandong, China.
Front Med (Lausanne). 2025 Aug 13;12:1625825. doi: 10.3389/fmed.2025.1625825. eCollection 2025.
Hepatic sinusoidal obstruction syndrome (HSOS) is a rare but life-threatening liver condition. The clinical utility of transjugular intrahepatic portosystemic shunt (TIPS) for HSOS remains unclear.
A systematic review and meta-analysis was performed across five databases (up to November 2024) to evaluate the efficacy and safety of TIPS in HSOS patients. Key outcomes included technical success, clinical response, portal pressure changes, survival, and complications.
Nineteen studies involving 465 patients were included. Pooled technical success and clinical response rates were 100 and 94.2%, respectively. TIPS significantly reduced portal pressure (mean PPG: -13.5 mmHg; PVP: -12.3 mmHg). The 3-month and 1-year survival rates were both 91.6%. Hepatic encephalopathy occurred in 13.2% of patients.
TIPS is a feasible and relatively safe treatment for HSOS, particularly in patients with pyrrolizidine alkaloid-induced HSOS (PA-HSOS). Further research is warranted to confirm its long-term benefits.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024620323, identifier CRD42024620323.
肝窦阻塞综合征（HSOS）是一种罕见但危及生命的肝脏疾病。经颈静脉肝内门体分流术（TIPS）治疗HSOS的临床效用仍不明确。
对五个数据库（截至2024年11月）进行系统评价和荟萃分析，以评估TIPS治疗HSOS患者的疗效和安全性。主要结局包括技术成功率、临床反应、门静脉压力变化、生存率和并发症。
纳入了19项研究，共465例患者。汇总的技术成功率和临床反应率分别为100%和94.2%。TIPS显著降低了门静脉压力（平均门静脉压力梯度：-13.5 mmHg；门静脉压力：-12.3 mmHg）。3个月和1年生存率均为91.6%。13.2%的患者发生了肝性脑病。
TIPS是一种治疗HSOS可行且相对安全的方法，尤其是对于由吡咯里西啶生物碱引起的HSOS（PA-HSOS）患者。有必要进行进一步研究以证实其长期益处。
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024620323，标识符CRD42024620323 。
