| 方志雄，程丹，方志宏，宋琳，黄新造，贺朗秋.胃冠状静脉栓塞联合脾栓塞治疗肝硬化消化道出血.[J].中南医学科学杂志.,2012,40(1):85-87. |
| 胃冠状静脉栓塞联合脾栓塞治疗肝硬化消化道出血 |
| Gastric Coronary Vein Embolization Combined Splenic Embolization for Gastrointestinal Bleeding in Cirrhosis of the Study |
| 投稿时间：2011-11-28 |
| DOI： |
| 中文关键词: 胃冠状静脉 脾红髓 栓塞 门静脉高压 |
| 英文关键词:gastric coronary vein spleen red pulp embolism portal hypertension |
| 基金项目: |
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| 中文摘要: |
| 目的探讨医用创面封闭胶结合游离大网膜在胆管癌、胰头癌手术中的作用并总结使用经验。方法分析湖南省人民医院肝胆外科收治的胆管癌、胰头癌外科手术患者112例，根据入院日期随机分组，其中手术中使用医用创面封闭胶结合游离大网膜作为手术创面、吻合口干预因素为干预组54例、手术中未行上述干预因素为对照组58例，对比两组患者在术后腹腔减压管引流量、吻合口瘘的发生两方面有无差异。结果干预组患者54例（使用医用创面封闭胶结合游离大网膜干预）术后1～7天腹腔减压管平均引流量78 mL，吻合口瘘4例，占7.4%；对照组患者58例（未行干预组）术后1～7天腹腔减压管平均引流量112 mL，吻合口瘘9例，占15.5%；两组患者在腹腔减压管平均引流量、吻合口瘘几率两方面比较，差异均有显著性（P<0.05）。结论医用创面封闭胶结合游离大网膜在胆管癌、胰头癌外科手术中可以起到良好的止血、减少创面渗液、降低吻合口瘘几率的作用，使患者受益。 |
| 英文摘要: |
| ObjectiveTo study the feasibility and efficacy of percutaneous transhepatic embolization of gastroesophageal varices combined with partial splenic embolization in the treatment of liver cirrhosis and hemorrhage.Methods26 cases of liver cirrhosis,portal hypertension and gastric variceal severe varicose bleeding in patients underwent percutaneous transhepatic portal vein angiography to identify the gastric coronary vein and short gastric vein,which were then embolized (with PVA or steel ring.et).Patients then underwent elective,selective splenic red pulp thrombosis to reduce portal pressure and relieve hypersplenism.Postoperative follow-up occurred at 15 months by endoscopy.ResultsOf the 26 patients treated for acute postoperative bleeding,22 (84.62%) maintained gastric coronary vein and short gastric vein occlusion at the 15 month postoperative follow-up.Of these,19 cases (73.08%) had persistent symptoms of upper gastrointestinal bleeding,while gastric varicose veins disappeared in 3 cases (11.54%).4 patients (15.38%) did not maintain occlusion of the gastric coronary vein and short gastric vein had recurrent esophageal and gastric bleeding.However,all 26 patients demonstrated significant improvements in symptoms related to hypersplenism.ConclusionPercutaneous transhepatic coronary vein embolization combined with selective splenic red pulp artery embolization demonstrates efficacy in the treatment of liver cirrhosis associated with gastrointestinal bleeding.Control of gastrointestinal bleeding can be achieved with reduced portal pressure,relief of hypersplenism,and may lead to a long-term curative effect in some patients.Therefore,Percutaneous transhepatic coronary vein embolization combined with selective splenic red pulp artery embolization presents as an attractive modality to be considered for the treatment of hemorrhage secondary to liver cirrhosis. |
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