多种材料联合栓塞治疗食管胃底静脉曲张临床疗效分析

Combined embolization with multiple materials for the treatment of esophagogastric varices:an analysis of clinical therapeutic effect

目的评价经皮经肝食管胃底静脉曲张栓塞术(PTO)的临床疗效及应用价值。方法以明胶海绵,无水乙醇和弹簧圈为栓塞剂联合栓塞治疗48例食管胃底静脉曲张破裂出血患者。结果 48例患者食管胃底曲张静脉均超选择插管,成功栓塞。17例急性上消化道出血患者中1例因全身状况差,术后第7天再次出血死亡。33例患者术后胃镜复查显示,胃底曲张静脉完全消失者27例,明显改善者6例,35例患者术后得到随访,随访4～36个月,再出血5例,死亡2例。结论多种材料联合栓塞治疗食管胃底静脉曲张栓塞术创伤小、操作安全、疗效确切,值得推广应用。

Objective To evaluate the clinical efficacy of percutaneous transhepatic combined embolization with multiple materials in treating esophagogastric varices.Methods A total of 48 patients with esophagogastric varices complicated by bleeding due to ruptured varices were enrolled in this study.Percutaneous transhepatic combined embolization with Gelfoam,ethanol and stainless steel coils was carried out in all patients.The clinical results were analyzed.Results Superselective catheterization and subsequent combined embolization procedure were successfully completed in all patients.In 17 patients with acute upper gastrointestinal bleeding,one died seven days after the treatment because of general failure.Postoperative gastroscopic examination was performed in 33 patients,which showed that esophagogastric varices were completely obliterated in 27 patients and markedly improved in six patients.A total of 35 patients were followed up for 4-36 months.During the follow-up period rebleeding occurred in 5 and death in 2 patients.Conclusion For the treatment of esophagogastric varices,combined embolization with multiple materials is mini-invasive,safe and effective.It is of value to popularize this technique in clinical practice.