胃冠状静脉栓塞术治疗门静脉高压症15例的疗效和并发症

The Results and Complications of Embolization of Gastric Coronary Vein for Treatment of 15 Patients with Portal Hypertension

胃冠状静脉栓塞加脾切除术阻断了食管下段、贲门和胃底的曲张静脉丛,止血效果好,术后脾功亢进消失。作者连续治疗15例,疗效满意者13例。胃冠状静脉栓塞操作简便,创伤较小,易于推广,是治疗门静脉高压症合并食管静脉曲张出血的一种有效方法。但是,该方法并非绝对安仝。本组有1例栓塞剂经门奇静脉分流引起肺血管栓塞死亡。另1例因栓塞范围过广,产生胃粘膜溃烂大出血。此类并发症应引起足够重视,寻求有效的预防方法。

Fifteen cases of portal hypertension with esophageal varices were treated by the method of gastric coronary vein embolization. Among them, 13 received simultaneous splenectomy. Ten cases suffered from esophageal varices hemorrhage in this series. One of them died of pulmonary vascular embolism caused by the embolism agent. Erosion of the gastric mucosa with bleeding occured in 4 cases. One case developed jaundice and ascites 4 months after the operation. Thirteen cases were followed-up for 10-16 months and their liver function was found to have been improved and they were able to resume their work. We consider that embolization of gastric coronary vein with splenectomy can control the esophageal varices hemorrhage effectively and make the hypersplenia disappear. However, it should be noted that these patients may suffer from pulmonary vascular embolism and gastric mucosal erosion with massive bleeding by the embolization.