介入断流术治疗门脉高压上消化道大出血的中远期随访结果

Interventional devascularization for the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension:mid-term to long-term results

目的评价介入断流术治疗门静脉高压症食管胃底曲张静脉出血的中、远期疗效。方法对49例肝硬化门静脉高压症患者施行介入断流术治疗,术后随访6～36个月,分析复发再出血、曲张静脉转归及并发症情况。结果技术成功率为98.0%(48/49),病死率为2.1%,术后1、6个月和1、2、3年再出血率分别为0、2.1%、12.5%、24.5%、27.9%。复发再出血原因分别为曲张静脉破裂再出血25.0%、门静脉高压性胃病58.3%、消化性溃疡16.7%。结论介入断流术治疗门静脉高压症上消化道出血是一种简单、安全、有效的方法。

Objective To assess the mid-term to long-term results of interventional devascularization in the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension. Methods Interventional devascularization was performed in 49 patients with upper gastrointestinal hemorrhage due to portal hypertension caused by cirrhosis. The patients were followed up for 6-36 months after the procedure. The recurrence of bleeding, postoperative complications and outcome, were observed and analyzed. Results The technical success rate was 98.0% （48/49） and the mortality was 2%. The re-bleeding occurrence rate at 1, 6, 12, 24 and 36 months was 0%, 2.1%, 12.5%, 24.5% and 27.9%, respectively. The causes of rebleeding included re-rupture of varieose vein （25%）, portal hypertensive gastropathy （58.3%）and peptic ulcer （16.7%）. Conclusion The interventional devascularization is a simple, safe and effective method for the treatment of upper gastrointestinal hemorrhage due to portal hypertension.