内镜下套扎及部分脾栓塞联合疗法在门脉高压性出血中的应用研究  

CLINICAL STUDY OF ENDOSCOPIC VARICEAL LIGATION COMBINED WITH PARTIAL SPLENIC EMBOLIZATION IN THE PATIENTS WITH ACUTE PORTAL UPPER DIGESTIVE TRACK BLEEDING

作　　者：郑燕[1] 徐维国[2] 李世东[1] 张东卫[1] 崔蓉[2] 

机构地区：[1]东省深圳市宝安区观澜医院消化内科,深圳518110 [2]四川省绵阳市中心医院

出　　处：《现代预防医学》2010年第23期4572-4574,共3页Modern Preventive Medicine

摘　　要：[目的]对内镜曲张静脉套扎EVL联合部分脾栓塞PSE治疗肝硬变食管静脉曲张出血的疗效进行评价。[方法]48例肝硬变食管静脉曲张出血并脾功能亢进患者,24例采用EVL联合PSE治疗,24例单用EVL治疗,比较两组近、远期静脉曲张根治率及再出血率、外周血象、肝功能及脾脏大小的变化。[结果]EVL联合PSE治疗组远期静脉曲张根治率显著高于EVL组(P﹤0.01),再出血率低于EVL组(P﹤0.05);EVL联合PSE治疗组外周血白细胞及血小板均较术前明显回升(P﹤0.05)。[结论]EVL联合PSE治疗肝硬变食管静脉曲张出血并脾功能亢进安全有效,近期、远期都有较高的食管静脉曲张根治率及较低的再出血率,并能有效改善血小板及白细胞计数,远期疗效肯定,EVL联合PSE治疗肝硬化并食管胃曲张静脉破裂出血是一种合理可行的方法。[Objective]To evaluate the therapeutic efficacy of endoscopic variceal ligation（EVL）combined with partial splenic embolization（PSE）in the treatment of patients with liver cirrhosis complicated with esophageal variceal bleeding.[Methods]In 48 patients with liver cirrhosis complicated with esophageal variceal bleeding and hypersplenism,24 cases were treated with EVL,combined with PSE（EVL-PSE group）,and 24 cases were treated with EVL（EVL group）.Short term and long term eradication rate and rebleeding rate were compared in the 2 groups.[Results]Long term eradication rate in the EVL-PSE group was significantly higher than that in the EVL group（P﹤0.01）and long term rebleeding rate was lower than that in the EVL group（P 0.05）.The levels of platelet and leucocyte in the EVL-PSE group were remarkably increased compared with previous levels（P﹤0.05）.[Conclusion]The treatment with EVL combined with PSE in patients with liver cirrhosis complicated with esophageal variceal bleeding and hypersplenism is safe and effective,which has higher short term and long term eradication rate and lower rebleeding rate,and long term therapeutic efficacy is superior to EVL and worth spreading.

关 键 词：食管静脉曲张 内镜套扎 脾栓塞 肝硬变 

分 类 号：R573[医药卫生—消化系统]