本文選題：門靜脈高壓　切入點(diǎn)：胃冠狀靜脈栓塞術(shù)　出處：《廣東醫(yī)學(xué)》2015年03期 　論文類型：期刊論文

【摘要】：目的探討幾種介入方式進(jìn)行胃冠狀靜脈栓塞術(shù)治療肝硬化門靜脈高壓出血的效果及價(jià)值。方法72例成功完成胃冠狀靜脈栓塞術(shù)患者,其中12例行單純經(jīng)皮經(jīng)肝穿刺胃冠狀靜脈栓塞術(shù)(PTVE),32例行PTVE聯(lián)合部分脾動(dòng)脈栓塞術(shù)(PSE),28例行經(jīng)頸靜脈肝內(nèi)門體分流術(shù)(TIPS)聯(lián)合經(jīng)頸靜脈冠狀靜脈栓塞術(shù)(TCVE)。比較3種手術(shù)方式止血效果,手術(shù)前后食管胃底靜脈曲張程度,脾、門靜脈系統(tǒng)壓力、血流量、血管內(nèi)徑,住院花費(fèi)及隨訪情況。結(jié)果 3種方式均止血成功,成功率均為100%。單純PTVE費(fèi)用低,但復(fù)發(fā)出血率明顯高于PTVE聯(lián)合PSE,以及TIPS聯(lián)合TCVE。TIPS聯(lián)合TCVE降門靜脈壓作用顯著,但住院費(fèi)用比PTVE聯(lián)合PSE更高。結(jié)論胃冠狀靜脈栓塞術(shù)聯(lián)合PSE或TIPS治療肝硬化門靜脈高壓出血均能取得明顯效果。如經(jīng)濟(jì)狀況允許,采用TIPS聯(lián)合TCVE遠(yuǎn)期療效更好。而在經(jīng)濟(jì)欠發(fā)達(dá)地區(qū),PTVE聯(lián)合PSE是一種不錯(cuò)的選擇。
[Abstract]:Objective to evaluate the efficacy and value of several interventional methods in the treatment of portal hypertension hemorrhage in cirrhotic patients. Methods 72 patients with gastric coronary vein embolization were treated successfully. Among them, 12 cases were treated by percutaneous transhepatic gastric coronary vein embolization (PTVEV). 32 cases were treated with PTVE combined with partial splenic artery embolization. 28 cases were treated with transjugular intrahepatic portosystemic shunt (PTVE) combined with transjugular coronary vein embolization. Before and after operation, the degree of esophageal and gastric varices, the pressure of spleen, portal vein system, blood flow, the diameter of blood vessel, the cost of hospitalization and follow-up were all successful, the success rate was 1000.The cost of simple PTVE was low. However, the rate of recurrent bleeding was significantly higher than that of PTVE combined with PSE, and that of TIPS combined with TCVE.TIPS combined with TCVE was significantly lower than that of TCVE. But the cost of hospitalization was higher than that of PTVE combined with PSE. Conclusion gastric coronary vein embolization combined with PSE or TIPS can achieve significant results in the treatment of portal hypertension hemorrhage due to cirrhosis. The long-term effect of TIPS combined with TCVE is better than that of TCVE, but it is a good choice in less developed areas.
【作者單位】： 南昌大學(xué)第二附屬醫(yī)院消化內(nèi)科;華東交通大學(xué)理學(xué)院;
【分類號(hào)】：R575.2

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4 游伶，

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