经皮穿脾食管胃底静脉栓塞术治疗血吸虫病上消化道出血

发布时间：2018-10-17 18:05

【摘要】：目的探讨经皮穿脾食管胃底静脉栓塞术(PTSVE)在治疗血吸虫病肝硬化上消化道出血中的应用价值。方法以血吸虫病肝硬化门脉高压合并食管胃底静脉曲张破裂出血患者16例(均为食管静脉套扎及硬化治疗术后再次出血患者)为研究对象,其中男12例,女4例。所有病例在X线透视引导下,实施PTSVE术。术后观察手术成功率、并发症发生率,术后1月复查CT,比较患者治疗前后静脉曲张程度。结果 14例(87.50%)患者PTSVE术取得成功,均获有效止血;2例(12.50%)失败;1例术后1周出现腹腔出血。术后1月复查CT,经评估显示患者食道静脉(P0.001)、食道旁静脉(P0.001)和胃底静脉(P0.001)曲张程度均较治疗前明显降低。结论 PTSVE治疗血吸虫病上消化道出血是安全有效的方法,该方法特别适合肝硬化严重,肝裂明显增宽,门静脉主干甚至分支裸露者。
[Abstract]:Objective to evaluate the value of percutaneous transsplenic esophagogastric fundus embolization (PTSVE) in the treatment of upper gastrointestinal hemorrhage due to schistosomiasis cirrhosis. Methods Sixteen patients (12 males and 4 females) with portal hypertension associated with esophageal and gastric varices bleeding after esophageal vein ligation and sclerotherapy were studied. All cases were treated with PTSVE under the guidance of X-ray fluoroscopy. The postoperative success rate and complication rate were observed, and the degree of varicose vein was compared before and after treatment with CT,. Results 14 cases (87.50%) were successfully treated with PTSVE, 2 cases (12.50%) failed, and 1 case had intraperitoneal hemorrhage 1 week after operation. One month after operation, CT, evaluation showed that esophageal vein (P0. 001), para-esophageal vein (P0. 001) and fundus gastric vein (P0. 001) were significantly lower than those before treatment. Conclusion PTSVE is a safe and effective method for the treatment of upper gastrointestinal hemorrhage due to schistosomiasis. This method is especially suitable for patients with severe cirrhosis, wide hepatic fissure, portal vein trunk or even bare branches.
【作者单位】：上海复旦大学附属金山医院介入科;
【基金】：上海市卫生和计划生育委员会资助项目(20134410)
【分类号】：R532.21;R573.2;R575.2

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