The Comparison Of Clinical Research Of Double Stents With Single Covered Stent In TIPS

Objective:Compare with different types of stents in TIPS to cure portal hypertension in liver function,hepatic encephalopathy,distributary channel narrow complications,and value the clinical application.Methods:Collected 77 patients between October2014 and April 2016 who suffered from esophagogastric variceal bleeding(EGVB)caused byportal hypertension(PHT)and recept the treatment of TIPS.and Randomly divided into three groups.26 patients with single covered stent,22 patients with double bare stents,29 patients with covered and bare stents,Clinical observation and follow-up of 77 patients,,respectively to compare the preoperative and postoperative portal tension changes with different types of stents,they were followed for 1w/1mo/3mo/6mo/12 mo after operation,to see whether stents patency rate,incidence of HE,liver dysfunction changeshave statistic difference。Result: 1.77 patients were completed the operation successfully,and it is totally placed 128 stents in 3 groups.including 55 coverde stents and 73 bare stents,There was no statistical difference between the clinical data and the preoperative liver function in 3groups 2.The portal vein pressure after treatment decreased significantly from 42.87±6.29cmH2Oto26.23±4.82cmH2 O,The difference was statistically significant,3.Portal pressure was no statistically significant among purely covered stents,double bare stents,covered and bare stents;4.stents patency rate:three type of stents were no statistically significant in total stents patency rate after TIPS 5.Hepatic encephalopathy(HE):compared the total rate of HE after TIPS in 1mo,6mo and 12 month made chi-square test,showed that postoperative in 1mo and 6mo were no statistically significant,while in 12 mo was statistically significant.made the four-layer table test showed that covered stents was statistically significant when compared with double bare stents,covered and bare stents.6.Liverdysfunction:Recorded child-pugh score of preoperative and 1w,1mo,3mo,6mo,12 mo after TIPS,compared with three type stents of the liver dysfunction,there have statistically significant with preoperative to 1w,3mo after TIPS,double bare stents compared with bare and covered stents was no statistically significant in 12 mo.bare and covered stents showed statistically significant after TIPS in 1w,3mo and 12 mo.Conclution: 1.Different type of stents in portal pressure,stents patency showed no statistically significant.2.After TIPS,compared with double bare stents,covered and bare stents,covered stents showed higher hepatic encephalopathy in long term postoperative.3.TIPS had great influence in liver dysfunction,the recover of liver dysfunction was slowly than double bare stents,bare and covered stents.Double bare stents in recovery of liver function is less than covered and bare stents,but in stents patency rate andhepatic encephalopathy,there is no statistically significant.But the cost is lower than coated stents,we can consider using it when the patient in the lack of funds.