A total of 61 patients with SPH-related VH from three hospitals were enrolled and classified into three groups: the SVR group (Group 1, n=24), the PSE+GVE group (Group 2, n=17), and the PSE group (Group 3, n=20). Baseline characteristics and clinical outcomes were compared among the groups.
The technical success rates for transhepatic and transsplenic SVR were 27.8% and 34.6%, respectively. No major complications were observed during any of the procedures. The median follow-up period was 53.2 months. The 2-year GI rebleeding rates for Group 1, 2, and 3 were 0%, 5.9%, and 35%, respectively. Groups 1 and 2 have a lower GI rebleeding rate (p = 0.002, p = 0.048, respectively) and better results of the degree of GV (p = 0.003, p = 0.044, respectively) compared to Group 3. No significant differences were found in 2-year GI rebleeding rates and the degree of GV between Group 1 and 2 (p = 0.415, p = 0.352, respectively).
SVR, PSE+GVE, and PSE seem safe and effective for management of SPH-related VH. SVR appears to be the superior treatment option. Transsplenic access may further increase the SVR success rate. PSE+GVE seems to have comparable outcomes in GV control and GI rebleeding rates compared to SVR, while superior to PSE.
方法:纳入来自三家医院的61例SPH相关VH患者,分为三组:SVR组(第1组,n=24),PSE+GVE组(第2组,n=17),和PSE组(组3,n=20)。比较各组的基线特征和临床结果。
结果:经肝和脾SVR的技术成功率分别为27.8%和34.6%,分别。在任何手术期间均未观察到重大并发症。中位随访期为53.2个月。第1、2和3组的2年胃肠道再出血率为0%,5.9%,35%,分别。与第3组相比,第1组和第2组具有更低的GI再出血率(分别为p=0.002,p=0.048)和更好的GV程度结果(分别为p=0.003,p=0.044)。第1组和第2组的2年胃肠道再出血率和GV程度没有显着差异(分别为p=0.415,p=0.352)。
结论:SVR,PSE+GVE,PSE对于SPH相关VH的管理似乎是安全有效的。SVR似乎是更好的治疗选择。经脾入路可进一步提高SVR成功率。与SVR相比,PSE+GVE在GV控制和GI再出血率方面似乎具有可比性。而优于PSE。