Abstract：
OBJECTIVE: Spontaneous portosystemic shunt (SPSS) can cause refractory hepatic encephalopathy (HE) in cirrhotic patients. The embolization of the shunt (ES) can resolve the HE, while the selective embolization of the splenic vein (SESV) can treat splenorenal shunts related HE. The aim of this study was to compare the clinical outcomes of ES and SESV when applied for the treatment of SPSS-induced refractory HE in cirrhotic patients.
METHODS: Patients with refractory HE who were treated with ES or SESV were retrospectively identified. The clinical outcomes were compared and analyzed.
RESULTS: The 6-month mortality after the ES procedure was significantly higher than that after the SESV procedure. During the 6-month follow-up, both the white blood cell and the platelet counts were significantly lower after the ES procedure than after the SESV procedure. There was a significant increase in aspartate aminotransferase levels after ES. However, the albumin levels as well as the Child-Pugh score and grade were found to be significantly improved at 6 months after the undertaking of an SESV (as compared with baseline).
CONCLUSIONS: The 6-month mortality was improved after SESV (as compared with ES) in the treatment of SPSS-induced refractory HE. A prospective multicenter study for validation is warranted.
METHODS: Patients with refractory HE who were treated with ES or SESV were retrospectively identified. The clinical outcomes were compared and analyzed.
RESULTS: The 6-month mortality after the ES procedure was significantly higher than that after the SESV procedure. During the 6-month follow-up, both the white blood cell and the platelet counts were significantly lower after the ES procedure than after the SESV procedure. There was a significant increase in aspartate aminotransferase levels after ES. However, the albumin levels as well as the Child-Pugh score and grade were found to be significantly improved at 6 months after the undertaking of an SESV (as compared with baseline).
CONCLUSIONS: The 6-month mortality was improved after SESV (as compared with ES) in the treatment of SPSS-induced refractory HE. A prospective multicenter study for validation is warranted.
摘要：
目的：自发性门体分流术（SPSS）可引起肝硬化患者的难治性肝性脑病（HE）。分流栓塞（ES）可以解决HE，而选择性脾静脉栓塞（SESV）可以治疗脾肾分流相关的HE。这项研究的目的是比较ES和SESV在肝硬化患者中应用于SPSS诱导的难治性HE治疗时的临床结果。
方法：对接受ES或SESV治疗的难治性HE患者进行回顾性分析。对两组临床治疗结果进行对比分析。
结果：ES术后6个月死亡率明显高于SESV术后。在6个月的随访中，ES手术后白细胞和血小板计数均显著低于SESV手术后.ES后天冬氨酸转氨酶水平显着增加。然而,发现在接受SESV后6个月,白蛋白水平以及Child-Pugh评分和分级显著改善(与基线相比).
结论：在SPSS诱导的难治性HE治疗中，SESV（与ES相比）后6个月死亡率改善。有必要进行前瞻性多中心研究进行验证。
方法：对接受ES或SESV治疗的难治性HE患者进行回顾性分析。
结果：ES术后6个月死亡率明显高于SESV术后。
结论：在SPSS诱导的难治性HE治疗中，SESV（与ES相比）后6个月死亡率改善。
