经皮经肝静脉曲张栓塞术治疗食管胃静脉曲张的关键技术及远期疗效分析  

Analysis of key techniques and long-term efficacy of percutaneous transhepatic variceal embolization for gastroesophageal varices

作　　者：张明艳[1] 胡锦华[1] 王广川[1] 崔屹[1] 刘福利[1] 张春清[1] 

机构地区：[1]山东大学附属省立医院消化内科,山东济南250000

出　　处：《中国介入影像与治疗学》2013年第4期196-200,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：山东省科技厅科技攻关计划项目[2010G020241]

摘　　要：目的探讨经皮经肝静脉曲张栓塞术(PTVE)的关键技术,分析其远期疗效。方法回顾性分析接受PTVE治疗并长期随访的153例肝硬化食管胃静脉曲张破裂出血患者的临床及随访资料。结果术后1、3、5年累计未出血率分别为96.6%、72.5%、54.6%。,累计生存率分别为95.3%、72.1%、43.4%。Cox回归分析表明Child-Pugh分级(RR2.40,95%CI 1.23～4.58,P=0.04)和曲张静脉程度(RR 2.03,95%CI 1.16～4.34,P=0.04)为再出血的独立预测因素,Child-Pugh分级是判断预后的唯一影响因素(RR 2.65,95%CI 1.32～6.91,P=0.04)。结论根据曲张静脉特点选择不同组织胶注射方式对提高食管胃静脉曲张栓塞术的远期疗效具有重要意义。Objective To explore the key techniques and the long-term efficacy of percutaneous transhepatic variceal embolization （PTVE） for gastroesophageal varices. Methods Long term following-up and clinical data of 153 cirrhotic patients with bleeding from gastroesophageal varices treated with PTVE were retrospectively analyzed. Results The 1, 3 and 5-year incidence of unbleeding was 96.6%, 72.5%, 54.6%, respectively. The 1, 3 and 5-year survival rate was 95.3%, 72.1%, 43.4%, respectively. Cox regression analysis showed Child-Pugh grading （RR 2.40, 95%CI 1.23-4. 58,P= 0.04） and the degree of varices （RR 2.03, 95%CI 1.16--4. 34, P= 0.04） were independent predictors of rebleeding. Child-Pugh grading was an independent prognostic factor （RR 2.65, 95%CI 1.32--6.91, P：0.04）. Conclusion The tissue adhensive should be injected in different ways according to the characters of varices, which can lead to better long-term efficacy of PTVE.

关 键 词：肝硬化 并发症 经皮经肝静脉曲张栓塞术 治疗结果 

分 类 号：R575.2[医药卫生—消化系统] R815[医药卫生—内科学]