超声内镜引导下弹簧圈置入联合组织胶注射治疗合并胃-肾分流/脾-肾分流的胃底静脉曲张出血疗效研究

Endoscopic ultrasound-guided coil placement combined with tissue glue injection in the treatment of gastric variceal bleeding with gastrorenal shunt/splenorenal shunt

目的探索超声内镜(EUS)引导下弹簧圈置入联合组织胶注射治疗合并胃-肾分流/脾-肾分流(GRS/SRS)的胃底静脉曲张出血的有效性和安全性。方法回顾性分析2017年12月至2023年5月期间,于首都医科大学附属北京友谊医院接受上述治疗患者的止血成功率、再出血率、异位栓塞率等。结果共48例患者纳入研究,男女比例为20∶28,平均年龄62.7(39.0~71.0)岁;其中伴有GRS 15例,伴有SRS 29例,GRS合并SRS 4例;分流通道最大直径平均为1.5 cm,最短直径平均为0.7 cm;操作成功率为100%,止血成功率为97.9%;弹簧圈平均直径11.3 mm,平均置入1.3个;组织胶平均注射量为6.3 mL;平均随访2.9年,再出血比例为18.8%,异位栓塞发生率为4.2%。结论EUS引导下弹簧圈联合组织胶治疗合并GRS/SRS的胃底静脉曲张出血效果良好,并发症发生率低。

Objective To explore the effectiveness and safety of EUS-guided coil placement combined with glue injection in the treatment of gastric varicose bleeding combined with GRS/SRS.Methods The hemostasis success rate,rebleeding rate,and ectopic embolization rate of the above patients in Beijing Friendship Hospital,Capital Medical University from December 2017 to May 2023 were retrospectively analyzed.Results A total of 48 patients were included in the study,with a male-female ratio of 20∶28,and an average age of 62.7(39.0-71.0)years.Among them,15 patients had GRS,29patients had SRS,and 4 patients had GRS combined with SRS.The average maximum diameter of the shunt channel was 1.5cm,and the average minimum diameter was 0.7 cm.The operation success rate was 100%,and the hemostasis success rate was 97.9%.The average diameter of the coil was 11.3 mm,and the average number of coils inserted was 1.3.The average injection volume of tissue glue was 6.3 m L.The average follow-up was 2.9 years,the rebleeding rate was 18.8%,and the incidence of ectopic embolism was 4.2%.Conclusion EUS-guided coil combined with tissue glue has a good effect on the treatment of gastric varicose bleeding combined with GRS/SRS,and the incidence of complications is low.