中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 10
Oct.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(10): 2068-2074

Effect of the multidisciplinary management model on the prognosis of patients with portal hypertension

DOI: 10.12449/JCH251017

  • Shenzhen Third People’s Hospital，Hepatology Medical Center of The Second Affiliated Hospital of Southern University of Science and Technology，National Key Discipline of Infectious Diseases，Shenzhen，Guangdong 518116，China

Research funding:

In-hospital Research Project of Shenzhen Third People’s Hospital (25270G1010);

Key Medical Discipline Construction Fund of Shenzhen (SZXK076)

More Information
  • Corresponding author: WANG Fang， kaixin919@163.com （ORCID： 0009-0003-0092-3403）
  • Received Date: 2025-01-25
  • Accepted Date: 2025-06-04
  • Published Date: 2025-10-25
    Abstract
  •   Objective  To investigate the effect of the multidisciplinary team （MDT） management model in improving the prognosis of patients with cirrhotic portal hypertension.  Methods  A total of 86 patients with cirrhotic portal hypertension who were admitted to Shenzhen Third People’s Hospital from May 2022 to July 2024 were enrolled， and according to whether the MDT treatment regimen was implemented， they were divided into execution group with 51 patients and non-execution group with 35 patients. Baseline clinical data were collected， and the patients were observed in terms of gastrointestinal bleeding， hepatic encephalopathy， liver cancer， and death from admission to the end of follow-up （January 2025）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves for the cumulative incidence rates of endpoint events （gastrointestinal bleeding， hepatic encephalopathy， liver cancer， and death）， and the Log-rank test was used for comparison between groups. The Cox proportional-hazards regression model analysis was used to investigate the effect of MDT management on the prognosis of patients.  Results  There were significant differences between the execution group and the non-execution group in diameter of the portal vein （t=1.216， P=0.017） and ascites （χ2=4.515， P=0.034） at baseline. The patients were followed up for 14.6±6.2 months， and the survival curve analysis showed that there was a significant difference in the cumulative incidence rate of gastrointestinal bleeding between the two groups （χ2=4.573， P=0.024）， while there were no significant differences in the incidence rates of other outcome events between the two groups （all P>0.05）. The Cox regression analysis showed that the execution group had a reduced risk of gastrointestinal bleeding （hazard ratio=0.262， 95% confidence interval： 0.110 — 0.630， P=0.003）.  Conclusion  Implementation of the MDT treatment regimen can significantly reduce the short-term risk of gastrointestinal bleeding in patients with cirrhotic portal hypertension， while its long-term benefits require further follow-up verification.

     

    • FullText(HTML)
  • loading
    • References(16)
  • [1]
    Beijing Society of Portal Hypertension, Beijing Medical Association; Portal Hypertension Expert Committee, Liver Disease Committee of Chinese Research Hospital Association; Liver Disease Committee of Chinese Research Hospital Association. Expert consensus on multidisciplinary diagnosis and treatment of cirrhotic portal hypertension(based on hepatic venous pressure gradient)[J]. J Clin Hepatol, 2021, 37( 9): 2037- 2044. DOI: 10.3969/j.issn.1001-5256.2021.09.008.

    北京医师协会门静脉高压专科医师分会, 中国研究型医院学会肝病专业委员会门静脉高压学组, 中国研究型医院学会肝病专业委员会. 肝硬化门静脉高压症多学科诊治(基于肝静脉压力梯度)专家共识[J]. 临床肝胆病杂志, 2021, 37( 9): 2037- 2044. DOI: 10.3969/j.issn.1001-5256.2021.09.008.
    [2]
    European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69( 2): 406- 460. DOI: 10.1016/j.jhep.2018.03.024.
    [3]
    BROWN RS Jr, BROWN KA, FLAMM S, et al. Screening and management of portal hypertension and varices in cirrhosis: Expert perspectives[J]. Hepatol Commun, 2025, 9( 4): e0682. DOI: 10.1097/HC9.0000000000000682.
    [4]
    AITHAL GP, PALANIYAPPAN N, CHINA L, et al. Guidelines on the management of ascites in cirrhosis[J]. Gut, 2021, 70( 1): 9- 29. DOI: 10.1136/gutjnl-2020-321790.
    [5]
    Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, Chinese Medical Association. Expert consensus on the diagnosis and treatment of esophageal and gastric variceal rupture bleeding in cirrhotic portal hypertension(2025 edition)[J]. Chin J Dig Surg, 2025, 24( 3): 271- 280. DOI: 10.3760/cma.j.cn115610-20241228-00590.

    中华医学会外科学分会脾及门静脉高压外科学组. 肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2025版)[J]. 中华消化外科杂志, 2025, 24( 3): 271- 280. DOI: 10.3760/cma.j.cn115610-20241228-00590.
    [6]
    KAPLAN DE, RIPOLL C, THIELE M, et al. AASLD practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis[J]. Hepatology, 2024, 79( 5): 1180- 1211. DOI: 10.1097/HEP.0000000000000647.
    [7]
    Chinese Society of Hepatology, Chinese Society of Gastroenterology, and Chinese Society of Digestive Endoscopology of Chinese Medical Association. Guidelines on the management of esophagogastric variceal bleeding in cirrhotic portal hypertension[J]. J Clin Hepatol, 2023, 39( 3): 527- 538.

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会消化内镜学分会. 肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J]. 临床肝胆病杂志, 2023, 39( 3): 527- 538.
    [8]
    de FRANCHIS R, BOSCH J, GARCIA-TSAO G, et al. Baveno VII- Renewing consensus in portal hypertension[J]. J Hepatol, 2022, 76( 4): 959- 974. DOI: 10.1016/j.jhep.2021.12.022.
    [9]
    JINDAL A, BHARDWAJ A, KUMAR G, et al. Clinical decompensation and outcomes in patients with compensated cirrhosis and a hepatic venous pressure gradient ≥20 mm Hg[J]. Am J Gastroenterol, 2020, 115( 10): 1624- 1633. DOI: 10.14309/ajg.0000000000000653.
    [10]
    TSENG Y, MA L, LV M, et al. The role of a multidisciplinary team in the management of portal hypertension[J]. BMC Gastroenterol, 2020, 20( 1): 83. DOI: 10.1186/s12876-020-01203-4.
    [11]
    LIU Z, SUO C, MAO X, et al. Global incidence trends in primary liver cancer by age at diagnosis, sex, region, and etiology, 1990-2017[J]. Cancer, 2020, 126( 10): 2267- 2278. DOI: 10.1002/cncr.32789.
    [12]
    SHI K, ZHANG Q, LI YX, et al. Research advances in the risk prediction models for chronic hepatitis B-related hepatocellular carcinoma[J]. J Clin Hepatol, 2020, 36( 10): 2315- 2319. DOI: 10.3969/j.issn.1001-5256.2020.10.034.

    时克, 张群, 李玉鑫, 等. 慢性乙型肝炎相关肝细胞癌风险预测模型的研究进展[J]. 临床肝胆病杂志, 2020, 36( 10): 2315- 2319. DOI: 10.3969/j.issn.1001-5256.2020.10.034.
    [13]
    CHINA L, TITTANEGRO T, CROCOMBE D, et al. Investigating potential confounding by indication when considering the association between proton pump inhibitor use, infection, hepatic encephalopathy and mortality in hospitalised decompensated cirrhosis: A post-hoc analysis of the ATTIRE trial[J]. EClinicalMedicine, 2023, 58: 101924. DOI: 10.1016/j.eclinm.2023.101924.
    [14]
    SANO T, AMANO K, IDE T, et al. A combination of hepatic encephalopathy and body mass index was associated with the point of no return for improving liver functional reserve after sofosbuvir/velpatasvir treatment in patients with hepatitis C virus-related decompensated cirrhosis[J]. Hepatol Res, 2023, 53( 1): 26- 34. DOI: 10.1111/hepr.13837.
    [15]
    LIN Y, LI JF, LI FY, et al. Role of neuroimmune communication via the gut-brain axis in the pathogenesis of hepatic encephalopathy[J]. J Clin Hepatol, 2024, 40( 12): 2518- 2523. DOI: 10.12449/JCH241224.

    林镛, 李炯汾, 李飞燕, 等. 肠-脑轴神经免疫通信在肝性脑病发病机制中的作用[J]. 临床肝胆病杂志, 2024, 40( 12): 2518- 2523. DOI: 10.12449/JCH241224.
    [16]
    NARDELLI S, GIOIA S, FACCIOLI J, et al. Hepatic encephalopathy- recent advances in treatment and diagnosis[J]. Expert Rev Gastroenterol Hepatol, 2023, 17( 3): 225- 235. DOI: 10.1080/17474124.2023.2183386.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (51) PDF downloads(10) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return