食管胃底静脉栓塞联合门静脉药物灌注治疗肝硬化门静脉高压症的初步疗效观察  

Esophago-gastric varices embolization and portal vein medicine infusion therapy for treatment of liver cirrhosis combined with port hypertension:primary report

作　　者：陈树平[1] 黄云龙[1] 谢宗贵[1] 游曼球[1] 周大桥[1] 胡元明[1] 

机构地区：[1]广州中医药大学深圳附属医院放射科,广东省深圳518033

出　　处：《中国基层医药》2006年第12期1988-1990,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省深圳市科技局资助项目(200602110)

摘　　要：目的探讨经皮穿刺食管胃底静脉栓塞术联合门静脉途径中西药物灌注对肝硬化门静脉高压症的治疗价值。方法肝硬化门静脉高压合并中重度胃底食管静脉曲张患者21例,采用数字减影血管造影术电视透视引导下经皮穿刺门静脉左支行门静脉造影、胃底食管静脉栓塞术及门静脉系统药盒植入术,并经药盒行门静脉区域性中西药物灌注治疗。结果21例患者行经皮门静脉左支穿刺插管、胃底食管静脉栓塞治疗及门静脉药盒系统植入术操作均获成功。门静脉系统药物灌注治疗后,压力下降(10.8±3.2)cm H2O,肝功能指标明显改善。随访(11±8.5)个月,无曲张静脉破裂出血发生。结论经皮穿刺胃底静脉食管静脉栓塞联合门静脉系统药物灌注治疗能有效降低静脉压力和食管胃底静脉破裂出血的发生率。Objective To evaluate the clinical value of percutaneous transhepatic esophago-gastric varices embolization and directly portal vein infusion therapy with western and Chinese medicines via port-catheter system to treat patients with liver cirrhosis combined with portal hypertension. Methods A total of 21 patients with liver cirrhotic and esophago-gastric varices were included this study. Percutaneous transhepatic puncturing of left branches of portal vein, esophago-gastric vhrices embolization and portal vein port-catheter system implantation were done under guiding by DSA. Through the port-catheter system, portal vein medicine infusion therapy was carried out. Results Interventional procedures of esophago-gastric varices embolization and portal vein port-catheter system implantation were success in all 21 cases. After one to three courses of directly portal vein medicine infusion therapy, portal vein pressure declined （10.8 ± 3.2）cmH2O. Liver function was improved significantly. 21 cases received following-up for （11 ± 8.5 ） months, and no varices bleeding happened in followed time. Conclusion Percutaneous transhepatic esophago-gastric varices embolization and directly portal vein infusion therapy may declined portal vein pressure effectively,and induced the rate of varices bleeding.

关 键 词：肝硬化 高血压 门静脉 食管和胃静脉曲张 栓塞治疗 导管-药盒系统 药物灌注治疗 

分 类 号：R575.2[医药卫生—消化系统]