直视下胃冠状静脉栓塞术治疗门静脉高压症

Gastric Coronary Vein Embolization under Direct Vision for Treatment of Portal Hypertension

报告直视下胃冠状静脉栓塞术治疗门脉高压症41例,8例急性大出血术后均能止血,手术死亡率7.31％。随访22例再出血率9.1％。提出冠栓术操作较简单,即时止血率高,可作为门脉高压症大出血首选术式。介绍栓塞剂TH胶,冠栓方法和操作体会。分析讨论了冠栓术疗效,异位栓塞发生原因和预防措施及同时作冠栓术和分流术等问题。

41 cases of portal hypertension have been treated by gastric coronary vein embolization (GCVE)with TH gel under direct vision since 1986. Acute bleeding discontinued in 8 cases after emergent operation, Operative mortality rate was 7.31%. Postoperative bleeding rate was 9.1% in followed up 22 cases. As procedure of GCVE is simplier and yields a satisfactory effect in controlling hemorrhage, it may be the first choice for portal hypertension with acute bleeding. The emboli agent TH gel, the technique and expirence of GCVE are introduced. Evaluation of GCVE, cause and prevention of ectopic cmbolization, GCVE plus portal-cava shunt in operation are discissed in detail.