经导管食道胃静脉曲张硬化治疗对门脉血流及肝功能的影响  

Influence of transcatheter esophageal-gastric variceal sclerotherapy on portal blood flow and liver function

作　　者：张倩 

机构地区：[1]新矿集团莱芜中心医院消化内科,山东莱芜271103

出　　处：《中国现代医生》2015年第26期89-92,共4页China Modern Doctor

摘　　要：目的探讨经导管食道胃静脉曲张硬化治疗对门脉血流及肝功能的影响。方法将我院2011年1月~2015年1月收治的93例肝硬化门静脉高压症并发食管胃底静脉曲张者按照就诊时间分为三组,硬化剂组（31例,于2011年1月~2012年1月期间就诊治疗）硬化剂治疗,组织黏合剂组（31例,于2012年2月~2013年2月期间就诊治疗）采用组织黏合剂治疗,硬化联合组织黏合剂组（31例,于2013年3月~2015年1月期间就诊治疗）采用硬化剂联合组织黏合剂治疗,比较三组患者治疗前后的肝功能指标及门静脉血流动力学变化。结果三组患者治疗后,血管内径均高于治疗前,但差异无统计学意义（P〉0.05）。三组患者治疗后的血流量及血流速度明显高于治疗前,差异具有统计学意义（P〈0.05）。联合组的血流动力学指标明显高于其他两组,差异具有统计学意义（P〈0.05）。三组患者治疗后ALB水平明显提高,PT明显缩短,差异具有统计学意义（P〈0.05）。三组患者术后TBIL及ALT水平均降低,差异具有统计学意义（P〈0.05）。结论对肝硬化门静脉高压症并发食管胃底静脉曲张患者采用硬化剂联合组织黏合剂进行治疗,可显著提高治疗效果,缓解患者的临床症状,值得临床推广应用。Objective To study the influence of transcatheter esophageal-gastric variceal sclerotherapy on the portal blood flow and liver function. Methods Ninety-three patients with liver cirrhosis and portal hypertension complicated with esophageal and gastric-fundus varices admitted to our hospital between January 2011 and January 2015 were divided into three groups according to the admission time. The hardener group（31 patients, treated between January2011 and January 2012） was given hardener treatment, the tissue adhesive group（31 patients, treated between February 2012 and February 2013） was given tissue adhesive treatment, and the hardener combined with tissue adhesive group（31 patients, treated between March 2013 and January 2015） was given hardener combined with tissue adhesive treatment. The liver function indicators and portal venous hemodynamic changes of the three groups before and after the treatment were compared. Results After the treatment, the blood vessel diameters of all the three groups were higher than those before the treatment, but the differences were not statistically significant（P〉0.05）. After the treatment, the blood flow volume and blood flow rates of all the three groups were higher than those before the treatment, with statistically significant differences（P〈0.05）. The hemodynamic indicators of the combination group were significantly higher than those of the other two groups, with statistically significant differences（P〈0.05）. After the treatment, the ALB level elevated significantly and PT shortened significantly in all the three groups, with statistically significant differences（P 0.05）. The postoperative TBIL and ALT levels of all the three groups reduced, with statistically significant differences（P〈0.05）. Conclusion For the patients with liver cirrhosis and portal hypertension complicated with esophageal and gastric-fundus varices, the application of hardener combined with tissue adhesive treatment can remarkably improve the treatment effect and al

关 键 词：硬化疗法 食管胃静脉曲张 肝功能 门脉血流 

分 类 号：R571.3[医药卫生—消化系统]