部分脾动脉栓塞联合内镜下硬化治疗重度食管静脉曲张的疗效观察  

Partial splenic embolization combined with endoscopic sclerotherapy for severe esophageal varicosity

作　　者：张克勤[1] 贾克东[1] 李娅娅[1] 李涛[1] 余海滨[1] 刘金明[1] 

机构地区：[1]南昌市第九医院肝五科,330002

出　　处：《介入放射学杂志》2013年第6期504-507,共4页Journal of Interventional Radiology

摘　　要：目的探讨部分脾动脉栓塞(PSE)联合内镜下硬化剂(EIS)注射治疗严重食管静脉曲张的疗效。方法 2009年6月至2011年2月收治伴有重度食管静脉曲张的肝硬化患者68例,随机分为PSE联合EIS治疗组(联合治疗组)32例和单纯EIS治疗组36例。联合治疗组先行脾动脉栓塞,然后常规胃镜下曲张静脉注射1%乙氧硬化醇硬化治疗;EIS组36例单纯给予1%乙氧硬化醇硬化治疗。所有患者在12个月内进行胃镜检查,观察完成曲张静脉系统根除治疗后所需硬化治疗次数、硬化剂用量。结果患者完成曲张静脉根除治疗所需平均治疗次数联合治疗组为1.5次,EIS组为2.7次;完成治疗所需总的硬化剂量在联合治疗组平均为38 ml,EIS组为94 ml。两者差异有统计学意义(P值分别<0.01和<0.05)。结论 PSE联合EIS治疗重度食管静脉曲张患者具有明显优势。Objective To evaluate thetherapeutic efficacy of partial splenic embolization （PSE） combined with endoscopic sclerotherapy （EIS） in treating severe esophageal varicosity. Methods During the period from June 2009 to Feb. 2011. a total of 68 patients with severe esophageal varicosis cause by cirrhosis were admitted to authors＇ hospital. The patients were randomly divided into group A （combination treatment group, n = 32） and group B （simple EIS group, n = 36）. Patients in group A received PSE together with EIS, while patients in group B received EIS only. For patients in group A PSE was first carried out, which was followed by EIS （injection of 1% lauromacrogol）, while for patients in group B only EIS was employed. Gastric endoscopy was performed in all patients within 12 months after the treatment. The times of endoscopic selerotherapy needed for a radical cure of varicosis and the total amount of sclerosis agent used in procedures were recorded. The results were analyzed. Results To obtain a radical cure of varicosis the mean times of endoscopic selerotherapy for patients of group A and group B were 1.5 and 2.7 respectively. The total amount of sclerosis agent used for patients of group A and group B were 38 ml and 94 ml respectively. Conclusion In treating severe esophageal varicosis cause by cirrhosis, PSE combined with E1S is obviously superior to simple EIS. （J Intervent Radiol, 2013, 22： 504-507）

关 键 词：食管静脉曲张 部分脾动脉栓塞术 内镜下硬化剂注射 

分 类 号：R575.2[医药卫生—消化系统]