摘要
目的探讨α-氰基丙烯酸正辛酯胃底食管曲张静脉栓塞术后仍有食管静脉曲张的患者联合内镜下套扎治疗的可行性和疗效。方法对肝硬化食管-胃底曲张静脉破裂出血的病人,应用TH胶为栓塞剂经皮肝穿行胃底-食管曲张静脉栓塞术、部分脾脏栓塞术后仍有食管静脉曲张的32例患者,择期行内镜下套扎。结果所有患者PTVE+PSE术均成功,套扎术仅有一例患者行2次套扎,余均为1次。2个月后,胃镜及钡餐检查,食道静脉曲张消失率为83.23%,余者均有明显缓解。随访3～18个月仅1例因胃粘膜病变出血,余者病情稳定。结论内镜下套扎是经皮TH胶栓塞的重要延续和补充,TH胶栓塞术又减少了EVL的次数及风险。联合手术安全,创伤小,止血率高,再出血率低,是治疗肝硬化后食道胃底静脉曲张理想方法。
Objective To discuss the feasibility and efficacy of percutaneous transhepatic embolization of gastroesophageal varices combined with endoscopic variceal ligation in gastroesophageal varices bleeding. Methods 32 patients underwent the TH glue embolization the main stem of the feeder vein of varices and it＇ s gastriofundeal branches and partial splenic embolization without esophageal varice disappeared com- bined with endoscopic variceal ligation（EVL）. Results The successful rate of VTVE＋PSE was 100%, Only one case had twice EVL,the oth- ers were all once. After EVL two months,reexamine by GI or gastroscopy,83.23% variceal vein disappear. In the follow-up period of 3 - 18 months 1 case bleeding by hemorrhagic mucosal gastropathy. Conclusion The endoscopic variceal ligation（EVL） is an important addition of the percutaneous transhepatic variceal embolization with TH glue, the TH glue embolization can reduce the frequency and the risk of EVL. The combined therapy is reasonable, comvenient with few complication, and safe with less injury. The effects are satisfactory for the control of gastroesophageal variceal bleeding.
出处
《中国现代医生》
2008年第27期31-33,共3页
China Modern Doctor
关键词
门静脉高压
α-氰基丙烯酸正辛酯
内镜下曲张静脉套扎
介入治疗
Portal hypertention
TH glue
α -octyl - eyanoacrylate
Endoscopic variceal ligation
Interventional therapy
