经皮经肝胃冠状静脉栓塞术固体栓塞物移(异)位及脱落的原因及处理方法  

Causes and management of solid embolic agents displacement and shift during percutaneous transhepatic variceal embolization

作　　者：杨卷红 熊玮[1] 薛克[1] 李金保[1] 孙培勤[1] 王亚莉[1] 

机构地区：[1]宝鸡市中心医院介入科,陕西宝鸡721008

出　　处：《中国介入影像与治疗学》2013年第10期581-584,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨经皮经肝胃冠状静脉栓塞术(PTVE)固体栓塞物移(异)位及脱落的原因及处理方法。方法对112例胃镜确诊食管胃底静脉曲张的肝硬化患者行PTVE,术中栓塞曲张的胃冠状静脉及胃短静脉,术毕栓塞穿刺道。观察术中及术后并发症。结果 3例出现固体栓塞物移(异)位、脱落,其中1例弹簧圈移位导致肺动脉栓塞,1例部分弹簧圈留置于脾静脉远端致血栓形成,1例穿刺道栓塞剂脱落导致患者死亡。结论 PTVE是预防及治疗食管胃底静脉曲张破裂出血的有效方法,细心操作、合理使用栓塞剂是提高手术成功率、降低并发症的关键。Objective To discuss the cause and management of displacement and shift of solid embolic agent during percu- taneous transhepatic variceal embolization （PTVE） in the treatment of esophago-gastric variees. Methods A total of 112 patients with liver cirrhosis and moderate-severe esophago-gastric varices underwent PTVE. Gastric coronary vein and short gastric vein were embolized. The puncture roads were embolized after PTVE, and the complications were observed. Results Displacement （shift） or off of solid embolic agents occurred in 3 patients. Splenic vein thrombosis occurred in 1 patient because of the coil setting in the distal splenic vein, pulmonary embolism occurred in 1 patient because of coil shift- ing, while embolic agent was off in 1 patient and led to death. Conclusion PTVE is an effective way in prevention and treatment of bleeding caused by esophago-gastric varices. Careful operation and reasonable selection of embolic agents are important to improve successful rate and reduce complications.

关 键 词：并发症 栓塞 治疗性 

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