经皮肝穿食管曲张静脉栓塞术和脾栓塞的临床应用

The clinical application of percutaneous transhepatic obliteration(PTO) of esophageal varices and partial spleen embolism(PSE)

目的 联合应用经皮肝穿食管曲张静脉栓塞术 (PTO)和部分性脾栓塞术 (PSE) ,探讨其对预防和治疗胃底和食管曲张静脉破裂出血合并脾功能亢进的治疗效果。方法 对 13例肝硬化门脉高压患者行PTO治疗 ,然后进行PSE。结果 全部病例术后造影及胃镜复查食管静脉曲张明显缓解或消失 ,未见再出血者。超声复查 ,脾脏栓塞面积达 5 0～60 % ,1～ 3个月后患者周围血象不同程度回升。结论 PTO加PSE是治疗食管静脉曲张破裂出血和脾功能亢进有效的非手术疗法 ,尤其适用于内科治疗无效又不宜手术的患者 。

Aim To study the efficacy of PTO and PSE combined in the management of gastroesophageal variceal hemorrhage and hypersplenism.Methods PTO is applied to treat 13 portal hypertension patients with cirrhosis,then PSE is applied.Results The varices were remited obviously or disappeared completely in all patients confirmed by ultrosound and endoscopy,and hemorrhage was not found again.The area of spleen infarct is up to 50-60%.The blood routine test showed some improvement in 1-3 months.Conclusions PSE after PTO is an effective non-operation method to treat gastroesophageal hemorrhage and hyper-splenism,especially to the patients who don't tolerate operation when internal medicine treatment is ineffective.