经皮经肝组织胶栓塞术与内镜下注射对治疗胃静脉曲张破裂出血的疗效比较  

Percutaneous transhepatic variceal embolization with 2-Octyl.Cyanoacrylate versus endoscopic cyano- acrylate injection for treatment of gastric variceal bleeding

作　　者：吴蕾[1] 冯华[1] 胡锦华[1] 王广川[1] 崔屹[1] 张春清[1] 

机构地区：[1]山东大学附属省立医院消化科,济南250014

出　　处：《中华消化内镜杂志》2013年第5期273-276,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的研究对比经皮经肝组织胶栓塞术（P1rVE）和内镜下注射（EVO）在预防胃静脉曲张破裂再出血方面的疗效。方法对77例胃静脉曲张破裂出血的患者（包括PTVE组32例，EVO组45例）进行回顾性分析，比较经2种方案治疗后，患者的再出血率、生存率和并发症等情况。结果门VE组随访（21．53±8．56）个月，共发生再出血4例（12．50％），EVO组随访（19．78±7．70）个月，共发生再出血17例（37．78％），再出血率差异有统计学意义（P=0．028）。PTVE组在第1、2、3年累计未出血率分别为93％、84％、84％，EVO组分别为75％、59％和49％（P=0．011）。2组间的死亡率（12．50％和17．78％）差异无统计学意义，并发症发生率（68．75％和68．44％）差异亦无统计学意义（P〉005）．结诊治疗冒静脉曲鞯P1、VE№EVO雨由右特和窖全目．Objective To compare the efficacy of a modified percutaneous transhepatic variceal em- bolization （FIVE） with 2-Octyl-Cyanoacrylate （2-OCA） and endoscopic variceal obturation （EVO） in pre- venting gastric variceal bleeding. Methods Seventy-seven patients with history of gastric variceal bleeding who underwent either EVO or PTVE were retrospectively reviewed. The rebleeding rate, survival rate and complications were compared between the two groups. Results EVO was performed in 45 patients ; PTVE was performed in 32 patients. During the follow-up （ 19. 78±7. 70 months in EVO group, vs. 21.53 ±8.56 months in PTVE group） , rebleeding occurred in 17 patients （37.78%） of EVO group, and in 4 patients （ 12. 5% ） of FTVE group （P =0. 028）. The cumulative rebleeding free rate for EVO was 75% , 59%, and 49% in 1,2, and 3 years, respectively; 93%, 84%, 84% for PTVE （P=0. 011）. There is no significant different in survival rate and the incidence of complications was similar in two groups. Conclusion Com- pared with EVO, PTVE with 2-OCA demonstrates advantage as an effective and safe method for gastric vail- ces.

关 键 词：胃静脉曲张 栓塞 治疗性 组织黏合剂 出血 

分 类 号：R575[医药卫生—消化系统]