肝硬化门静脉高压症双介入治疗的临床应用  

Clinical Application of the Double Interventional Therapy of Portal Hypertension Caused by Cirrhosis

作　　者：薛克[1] 权晖 何伟[1] 顿国亮 孙培勤[1] 茹则堃 熊伟[1] 

机构地区：[1]宝鸡市中心医院放射科,陕西宝鸡721008 [2]宝鸡市中心医院B超室,陕西宝鸡721008

出　　处：《实用放射学杂志》2007年第9期1236-1238,共3页Journal of Practical Radiology

摘　　要：目的探讨双介入治疗对肝硬化门静脉高压性上消化道出血、脾功能亢进的临床价值及并发症的预防。方法对11例确诊为肝硬化门静脉高压合并上消化道出血、脾功能亢进的患者,在B超引导下经皮肝门脉穿刺成功后,将导管超选择插入胃冠状静脉,再经股动脉穿刺插管、超选插入脾动脉分支,混合应用无水酒精、明胶海绵、不锈钢弹簧圈,进行双介入栓塞(胃底食管曲张静脉及部分脾脏栓塞)治疗。结果11例患者术后均有不同程度的发热、腹痛、恶心及呕吐等栓塞后综合征,经对症治疗后缓解、症状消失。24 h^1周白细胞、血小板明显升高。12月内上消化道出血控制率达100%。结论双介入治疗门脉高压性上消化道出血、脾功能亢进,疗效确切。Objective To study the clinical value of double interventional method for the therapy of upper gastrointestinal bleeding and hypersplenism caused by the portal hypertension with cirrhosis. Methods 11 patients with portal hypertension and cirrhosis companied with upper gastrointestinal bleeding and hypersplenism were involved in the study. Under the guidance of B - ultrasound, percutaneous punctures of portal vein of liver and femoral artery were done respectively,the catheters were inserted into the vena coronaria ventriculi and branches of splenic artery selectively and then embolized them with mixture of alcohol,sponge gel and metal coin. Results The bleeding in all cases was controlled after embolization, and did not recurred followed - up for 12 months. The number of leukocyte and platelet was increased from 24 h to 1 week after the therapy. The side effects of therapy such as fever, stomachache, nausea and vomiting appeared after therapy, and disap- peared after symptomatic treatment. Conclusion The curative effect of double interventional method is well in treating upper gastrointestinal bleeding and hypersplenia caused by the portal hypertension with cirrhosis.

关 键 词：门静脉高压 食管胃底静脉曲张 脾功能亢进 介入治疗 

分 类 号：R575[医药卫生—消化系统] R815[医药卫生—内科学]