部分性脾动脉栓塞术对肝硬化患者易致消化道出血因素的影响  

Influence of partial splenic embolization on the factors related to alimentary canal bleeding in hepatocirrhosis

作　　者：梁玉国[1] 楚秀菊 吴福仓 扬根领 周伟[1] 

机构地区：[1]山东省济宁市传染病医院消化科,272031

出　　处：《中华消化内镜杂志》2005年第6期388-390,共3页Chinese Journal of Digestive Endoscopy

基　　金：山东省济宁市科学技术委员会科研立项编号(医药卫2002-17)

摘　　要：目的探讨部分性脾动脉栓塞术对肝硬化患者预防消化道出血的作用。方法将49例患者按人选顺序随机分为治疗组28例,对照组21例。治疗组在对照组治疗的基础上给予部分性脾动脉栓塞术,并于术前、术后7d、术后1个月、术后6个月、术后1年,分别观察血常规、凝血酶原时间、肝功能、B超及胃镜检查。结果术后7d治疗组外周血血小板、白细胞计数明显上升。显著高于对照组(P<0．01)。凝血酶原时间明显缩短,显著低于对照组(P<0．01)。术后6个月及1年治疗组食管静脉曲张明显好转,其好转率较对照组差异有统计学意义(P<0．01、P<0．05)。术后6个月及1年,治疗组门脉高压性胃病的好转率显著高于对照组(P<0．01、P<0．05)。结论部分性脾动脉栓塞术对肝硬化患者易致消化道出血的3个因素均有明显疗效,值得推广应用。Objective To explore the influence of partial splenic embolization （PSE） on the factors related to alimentary canal bleeding in hepatocirrhosis. Methods Forty-nine cases of hepatocirrhosis patient with alimentary canal hleeding were selected according to the sequence of entrance. In these patients, 28 cases were set in treatment group and the rest 21 cases were control group. Besides basic therapeutic measures PSE technique were given to the patients of treatment group, while the patients in control group received basic therapeutic measures only. And the blood routine test, prothrombin time（PT） , liver function tests, B type uhrasonography and gastroscopy were conducted or observed respectively before operation and 7 days, 1 month, 6 months ,1 year after operation. Results ①7 days after operation, the count of blood platelets and white blood cells in peripheral blood of therapy group were higher obviously than those of control group（P 〈 0. 01 ）. PT was shorter than that of control grnup（P 〈 0. 01 ）. ②6 months and 1 year after operation, variees of esophagus in therapy group improved obviously than those of control group（ P 〈 0. 01, P 〈 0. 05 ）. ③6 months and 1 year after operation, portal hypertensive gastropathy of therapy group improved obviously than that of control group（P 〈 0. 01 , P 〈 0. 05 ）. Conclusion It has obvious effect on the three factors related to alimentary canal bleeding in hepatocirrhnsis and is worthy to popularize to adopt PSE technique in these patients.

关 键 词：栓塞术 脾动脉 肝硬化 消化道出血 食管静脉曲张 

分 类 号：R575.2[医药卫生—消化系统]