胃冠状、胃短静脉栓塞术对胃底静脉曲张出血疗效评价

The effect of embolization of gastric coronary and short gastric veins on the control of hemorrhage from (gastric) varices

目的探讨胃冠状静脉、胃短静脉栓塞术对胃底静脉曲张出血治疗的价值.方法32例肝硬化并食管胃底静脉曲张出血经内镜下套扎、硬化治疗后仍有出血的患者,经皮经肝穿刺行胃冠状静脉、胃短静脉栓塞治疗.栓塞剂主要为无水乙醇、钢圈和明胶海绵.均行1次栓塞治疗,并经3～11个月随访,胃镜复查.结果29例复查胃镜,其中21例(72.4%)胃底曲张静脉完全消失,8例(27.6%)胃底曲张静脉明显减轻,无红色征及糜烂.随访期内有1例(3.1%)因门脉高压性胃炎致黏膜糜烂出血.未发现明显并发症.结论经皮经肝穿刺行胃冠状静脉、胃短静脉栓塞治疗具有消除胃底静脉曲张,并可预防出血的作用.

Objective To study the effect of embolization of gastric coronary and short veins on the control of hemorrhage from gastric fundal varices. Methods Thirty-two patients with liver cirrhosis and hemorrhage from esophagus and fundal varices, who still had variceal bleeding after endoscopic banding or sclerosing of esophageal varices were included in the study. Gastric coronary and short veins were (embolized) by percutaneous, transhepatic embolization with absolute alcohol, steel ring, or gelfoam. The follow-up of 3 to 11 months was carried out after embolization. Results The follow-up endoscopy showed that the varices of gastric fundus disappeared completely in 21 of 29 patients (72.4%), and (eleminated) partially in 8 patients (27.6%). Only one patient (3.1%) had re-bleeding due to portal (hypertensive) gastropathy in the follow-up period. No obvious complication was found in these patients. Conclusions The varices of gastric fundus could be obliterated by percutaneous, transhepatic embolization of gastric coronary and short veins.