胃冠状静脉联合脾动脉栓塞治疗肝硬化上消化道出血效果分析

An Analysis of the Effect of Gastric Coronary vein and Splenic Arterial Embolization on Treatuent of Upper Gastrointestinal Bleeding of Liver Cirrhosis

目的分析胃冠状静脉联合脾动脉栓塞治疗肝硬化上消化道出血的临床疗效。方法对牡丹江某医院收治的34例肝硬化门静脉高压合并胃底静脉重度曲张出血患者实施经皮肝穿刺胃冠状静脉栓塞以及脾红髓小动脉栓塞联合治疗,术后随访1年,对其术中造影表现、术后并发症及临床疗效进行分析。结果 34例患者术后经造影检查显示胃冠状静脉闭塞,术后无严重并发症发生,术后随访29例(85.3%)无上消化道出血症状,23例(67.6%)无胃底静脉曲张表现,4例(11.8%)复发胃底静脉曲张,2例(5.9%)复发胃底出血,全部患者的脾功能亢进情况得到显著改善。结论胃冠状静脉联合脾动脉栓塞治疗肝硬化上消化道出血,可有效控制消化道出血、改善脾功能亢进情况,且并发症少、复发率低,可推广应用。

Objective To analyze the clinical efficacy of the gastric coronary vein combined with splenic artery embolization on the treatment of upper gastrointestinal bleeding of liver cirrhosis. Method 34 cases of hepatic portal hypertension with cirrhosis and severe gastric vein varicose bleeding in patients received in a hospital of Mudaniiang city were given the treatment of percutaneous transhepatic embolization of gastric coronary vein and splenic red pulp small artery embolization. During one-year follow-up after the treatment, the patients＇ in- tra-operative angiography findings, postoperative complications and clinical efficacy were analyzed. Results After the operation, 34 cases showed gastric coronary vein occlusion under angiography. The follow-up showed that 29 cases （85.3%） had no symptoms of upper gastrointestinal bleeding, 23 cases （67.6%） had no varices performance, 4 cases （11.8%） had recurrent varices, 2 cases （5.9%） relapsed gastric bleeding and hypersplenism in all the patients improved significantly. Conclusion The treatment of gastric coronary vein combined with splenic artery embolization on upper gastrointestinal bleeding of liver cirrhosis can effectively control gastrointestinal bleeding and improve hypersplenism with few complications and low recurrence, worthy of further promotion and application.