| 杨四清， 刘义， 程正友， 龙焱华， 汪浩， 许觅， 李凤桂.介入血管栓塞联合内镜注射硬化治疗食管胃底静脉曲张[J].放射学实践,2014,(07):837-840 |
| 介入血管栓塞联合内镜注射硬化治疗食管胃底静脉曲张 |
| Treatment of esophagogastric varices with interventional vascular embolization in combination with sclerotic agent injection via endoscopy |
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| DOI：10.13609/j.cnki.1000 0313.2014.07.026 |
| 中文关键词: 球囊阻断逆行静脉闭塞 食管静脉曲张 胃肾分流 泡沫硬化剂 |
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| 【摘要】目的：观察多种介入方法联合应用治疗食管胃底静脉曲张的临床效果。方法：25例食管胃底静脉曲张患者，分别行经皮肝穿冠状静脉栓塞（PTVE）和球囊阻断静脉逆行硬化闭塞胃静脉曲张（BRTO），并发脾功能亢进者，同时行部分脾动脉栓塞（PSE）。术后对有残留食管静脉曲张的病例行内镜硬化剂注射治疗（EIS）。全部治疗完成后常规临床观察，并定期复查胃镜和CT增强扫描。结果：25例患者，7例行PTVE+PSE； 11例行BRTO，6例行BRTO+PSE，1例BRTO手术失败；术后11例患者接受内镜注射治疗一次，4例患者接受二次注射治疗。3例患者死亡，其中1例于术后2月死于再发出血。结论：多种介入方法联合应用，具有可靠的预防上消化道出血的效果。 |
| 【Abstract】Objective:To evaluate the clinical efficacy of esophagogastric varices treatment with various interventional approaches in combination.Methods：For 25 patients with esophagogastric varices,percutaneous transhepatis variceal embolization (PTVE) or balloon-occluded retrograde transvenous obliteration (BRTO) was performed respectively.Partial splenic artery emoblization was performed simultaneously in patients accompanied with hypersplenia.Sclerotherapy via endoscopy (EIS) was used in patients with remained esophageal varices during follow-up.Clinical follow-up endoscopy and enhanced CT were performed routinely in patients having all treatments accomplished.Results：Of the 25 patients,PTVE+PSE were performed in 7 cases,BRTO in 11 cases,and BRTO+PSE in 6 cases.BRTO failed in one case.Sclerotherapy via endoscopy injection was performed once for 11 patients with remained esophagogastric varices after primary treatment，it was performed twice for 4 patients.Three patients died,one of them due to recurrent bleeding 2 months after treatment.Conclusions：Various interventional approaches in combination has reliable efficacy in preventing recurrent bleeding of esophagogastric varices. |
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