摘要
目的探讨经皮穿肝曲张血管栓塞术(PTVE)对门静脉压力、门静脉血流量的影响及食管胃底曲张静脉出血、止血、延长再出血间期的价值。方法36例食管胃底曲张静脉破裂大出血患者行PTVE治疗,术中测门静脉压力,术前、术后彩色多普勒测门静脉血流量。另选择35例药物治疗患者作为对照组。结果PTVE组成功率94.87%,活动性出血全部成功止血;曲张血管栓塞后与栓塞前比较,门静脉压力明显升高(P<0.05),门静脉血流量变化不明显(P>0.05)。术后PTVE组、对照组分别平均随访420.36、250.56d,再出血率分别为10%、42.86%,半数再出血时间分别为430、131d;两组再出血率、半数再出血时间比较有统计学意义(P<0.01)。结论PTVE是一种安全、有效的止血措施,与药物治疗相比可以显著降低病死率,延长再出血间期。
Objective： To evaluate the effect of percutaneous transhepatic varices embolization （PTVE） on portal vein pressure, portal venous flow, the control of active gastroesophageal hemorrhage and rebleeding frequency. Methods： 36 patients were treated with PTVE. Portal vein pressure was measured in the splenic vein during procedures. Portal venous flow was measured by color Doppler ultrasonography before and after procedure. The control group were 35 patients who received medical therapy. Results： The procedure was successfully completed in 94.87% of patients. Variceal hemorrhage was controlled in 100% of actively bleeding patients. After PTVE, mean portal vein pressure significantly increased （P〈0.05）. Mean portal venous flow changed slightly （P〉0. 05）. Recurrent hemorrhage occurred in 10% patients at mean follow-up of 420.36 day after procedure, and in 42. 86% patients at mean follow-up of 250. 56 day in medical therapy. Recurrent hemorrhage was significantly decreased in patients treated with PTVE （P〈0.01）. Conclusions： PTVE is proved to be an effective, safe emergent treatment for variceal hemorrhage, and can decrease recurrent hemorrhage, decrease death from hemorrhage.
出处
《山东医药》
CAS
北大核心
2006年第10期1-2,共2页
Shandong Medical Journal
基金
山东省科学技术厅项目(2004GG2202168)
关键词
食管和胃静脉曲张
出血
栓塞
治疗性
esophageal and gastric varices
hemorrhage
embolism, therapeutic
