经自发性胃－肾静脉分流道栓塞胃底静脉曲张（附四例报告）

Transcatheterobliterationofgastricvaricesthroughthespontaneousgastro┐renalshunt(areportof4cases)

目的：报告４例经自发性胃－肾静脉分流道逆行栓塞胃底静脉曲张的初步结果，旨在评价这一技术的临床应用可行性。材料和方法：４例均有反复呕血或黑便史，胃镜检查均有中度以上胃底及食管静脉曲张。２例因无分流指征而行单纯胃底静脉曲张栓塞术，另２例与经颈静脉肝内门腔静脉内支架分流术（ＴＩＰＳＳ）联合进行。结果：４例技术均成功，无并发症，术后胃底静脉曲张几乎完全消失。结论：经自发性胃－肾静脉分流道逆行栓塞胃底静脉曲张是一安全可行的技术，对闭塞胃底静脉曲张有良好效果；与ＴＩＰＳＳ术中胃冠状静脉栓塞联合应用可减少误栓并发症，加强栓塞效果。

Purpose:Toevaluatethefeasibilityofclinicalapplicationofretrogradespontaneousgastro-renalshunt(SGRS)inthetreatmentofgastroesophagealvarices.Materialsandmethods:Fourpatientshadhistoryofrecurrentbleedingresultingfromseveregastroesophagealvaricescon-firmedbyendoscopicexamination.2casesweretreatedbytheprocedurealone,and2casesweremanagedincombinationwithTIPSS.Results:Technicalsuccesswasobstainedinal4patientswithnocomplications.Folow-upendoscopicexaminationdemonstratedalmostcompletedisappearanceofthefundicvaricesinalcases.Conclusion:SGRSwasasafeandefectivetechniqueintheobliterationofgastricvarices.ThisprocedurewhencombinedwithcoronaryveinembolizationofTIPSSmightre-ducethepotentialriskofembolicagentgoingintotherenalshuntandenhancethetherapeuticefect.