摘要
目的 探讨介入断流术前后门静脉血液动力学的改变及临床价值。资料与方法 对 50例门静脉高压症患者行经皮经肝穿刺门静脉 ,行食管胃底曲张静脉栓塞 (PTVE)治疗 ,PTVE后行部分性脾栓塞 (PSE)治疗。其中2 8例PTVE后 2周行PSE ,2 2例PTVE术中同时行PSE。 50例PTVE手术前后测自由门静脉压 (FPP)。 2 2例PSE后再次测FPP。结果 50例PTVE术后FPP均有不同程度增高。 2 2例PTVE同时行PSE者 ,术后再次测FPP ,FPP均有不同程度下降。 50例PTVE术后造影显示 ,47例完全闭塞 ,3例不完全闭塞 ,仍有曲张静脉显示 ,但血流速度变慢。随访 3～ 50个月 ,再出血 2例 ,其中 1例于术后 2 0天 ,1例于术后 1 4个月。结论 PTVE联合PSE治疗门静脉高压症是一种合理而可行的方法。它既能有效止血 ,又能适当降低门静脉压 ,减少胃黏膜病变 ,降低再出血率 ,不影响肝脏“营养因子”
Objective To discuss the hemodynamic change after interventional devascularization for portal hypertension and its clinical significance. Materials and Methods Percutaneous transhepatic gastro esophageal variceal embolization (PTVE) was performed in 50 patients with portal hypertension, of which partial splenic embolization (PSE) was carried out during the same procedure in 22 and two weeks later in 28. Free portal pressure (FPP) of both before and after the PTVE procedure was estimated in all 50 cases. Re estimation of FPP after PSE was conducted in 22 cases.Results An increase of FPP after PTVE to different degree was seen in all 50 cases. In 22 patients who received both PTVE and PSE a decrease of FPP after the whole procedure was demonstrated. On angiographs after PTVE, complete occlusion of the varices was seen in 47 cases, and incomplete occlusion with the flow slowing down in 3 cases. During a follow up of 3～50 months, recurrent bleeding happened in 2 patients, which occurred at 20 days (n=1) or 14 months (n=1) after the procedure.Conclusion PTVE together with PSE is a rational and feasible treatment for portal hypertension. It can not only stop the bleeding effectively, but also lower the portal pressure and reduce mucosal damage of the stomach.
出处
《临床放射学杂志》
CSCD
北大核心
2002年第12期972-975,共4页
Journal of Clinical Radiology
关键词
门静脉高压症
血液动力学
PTVE
术前
术后
经皮经肝曲张静脉栓塞
Percutaneous transhepatic variceal embolization Partial splenic embolization Portal vein Hypertension Embolization
