关键词: 肝硬化, 门静脉高压, 自发性门体分流, 预后

Abstract: Objective To investigate the incidence and prognosis of spontaneous portosystemic shunt in patients with cirrhosis. Methods A total of 220 patients with cirrhosis complicated with portal hypertension admitted to our hospital from June 2017 to November 2018 were selected. All patients received the transjugular intrahepatic portosystemic shunt (TIPS), and patients with spontaneous portosystemic shunt received the coil, angiosclerotic agent or Amplatzer occlude. The incidence rate of spontaneous portosystemic shunt was recorded. The death and postoperative complications were also recorded during the postoperative 1-year follow-up. Results The incidence rate of spontaneous portosystemic shunt was 38.64% (85/220). In patients with spontaneous portosystemic shunt, the postoperative 1-year cumulative incidence rates of hepatic encephalopathy, ascites and upper gastrointestinal hemorrhage were 32.41%, 36.47% and 23.53%, respectively. The stent patency rate decreased to 78.82% 1 year after operation. The postoperative 1-year mortality had no significant difference between patients with and without spontaneous portosystemic shunt (P> 0.05). The postoperative 1-year cumulative incidence of hepatic encephalopathy of patients with spontaneous portosystemic shunt had no difference with that of patients without spontaneous portosystemic shunt (32.41% vs 21.48%, P> 0.05). The history of hepatic encephalopathy was an independent risk factor for hepatic encephalopathy within 1 year after TIPS (P<0.05). Conclusion In this study, the incidence of spontaneous portosystemic shunt in cirrhotic patients with portal hypertension was 38.64%. TIPS combined with occlusion can effectively reduce portal pressure. Moreover, the incidence of hepatic encephalopathy within 1 year after operation is related to the history of hepatic encephalopathy before operation.

Key words: Cirrhosis, Portal hypertension, Spontaneous portosystemic shunt, Prognosis