食管曲张静脉内镜结扎联合脾栓塞术疗效观察

Effect of endoscopic esophageal varical ligation combined with pantical splenic embolization for esophagus varices

目的探讨内镜曲张静脉结扎(EVL)联合脾栓塞术(PSE)治疗门静脉高压症的疗效.方法对35例门静脉高压症合并食管曲张静脉出血和脾功能亢进病人实施EVL联合PSE治疗.结果 35例病人食管曲张静脉完全闭塞,平均随访1 a(3～36个月),复发出血率8.6%;脾栓塞术后脾脏明显缩小,外周血白细胞与血小板均显著升高(P＜0.001),脾静脉、门静脉内径回缩,主干流速降低,主干流量减少.结论 EVL联合PSE疗法是治疗门静脉高压症食管静脉曲张出血和脾功能亢进的有效方法.该联合疗法比单独EVL更快闭塞曲张静脉,复发出血率低;较外科手术简单,侵袭性小.

To evaluate the feasibility and eflicacy of a method of endoscopic esophageal variceal ligation(EVL) combined with partial splenic embolization (PSE) for the patients with portal hypertension. Thirty-five patients with portal hypertension under went EVL-PSE accomparied with esophageal variceal bleading and hypersplenism. The patient′s Esophageal variceals were complete embolized. During 3~36 months follow up, recurrent bleeding was 8.6%,postoperactive the splent volumes were less, around blood white cell and platelet count were significantly increase (P<0.001), splenic vein, postoperative portal trunk were less and its flow volume and velocity were significantly reduced. [Conclusions] EVL-PSE can be carried out sufely in the clinical treatment for patients with portal hypertension. It can be quick embolized and less injured than surgery.