EGVB应用TIPS联合GCVE与单纯TIPS治疗的效果对比  

Comparison on effects of TIPS combined with GCVE and TIPS alone on EGVB

作　　者：胡鸿 黄琳竣 HU Hong;HUANG Linjun(Department of Interventional Medicine,Nanchong Central Hospital,Nanchong 637000,China)

机构地区：[1]南充市中心医院介入医学科,四川南充637000

出　　处：《实用放射学杂志》2020年第4期624-627,共4页Journal of Practical Radiology

摘　　要：目的分析食管胃底静脉曲张破裂出血(EGVB)应用经颈静脉肝内门体分流术(TIPS)联合胃冠状静脉栓塞术(GCVE)与单纯TIPS术治疗的效果.方法2016年1月至2018年1月收治的80例EGVB患者按术式分为联合组(TIPS联合GCVE,n=39)、对照组(TIPS,n=41).比较2组术前后门静脉压水平、并发症发生率及随访期内再出血发生率,绘制Kaplan-Meier生存曲线比较2组生存情况.结果术后2组门静脉压力较术前均显著下降(P<0.05),但门静脉压力及并发症总发生率组间差异均无统计学意义(P>0.05);同时,联合组随访期内再出血发生率(5.12%)显著低于对照组(21.95%)(P<0.05),累积生存函数(97.37%)显著高于对照组(69.80%)(P<0.05).结论较单纯TIPS,联合GCVE不仅可有效降低再出血及死亡风险,且不增加手术并发症风险,值得临床重视.Objective To analyze the effects of transesophageal intrahepatic portosystemic shunt(TIPS)combined with gastric-coronary venous embolization(GCVE)and TIPS alone on esophagogastric variceal bleeding(EGVB).Methods 80 patients with EGVB admitted between January 2016 and January 2018 were divided into combination group(TIPS combined with GCVE,n=39)and control group(TIPS,n=41)according to the surgical methods.The portal vein pressure level,incidence of complication and incidence of rebleeding during the follow-up period were compared between the two groups.Kaplan-Meier survival curve was drawn to compare the survival in the two groups.Results The portal vein pressure of the two groups was significantly decreased after operation(P<0.05),there was no significant difference in portal vein pressure or total incidence of complication between the two groups(P>0.05).The incidence of rebleeding of combination group was significantly lower than that of control group during the follow-up period(5.12%vs 21.95%)(P<0.05),and the cumulative survival function was significantly higher than that of control group(97.37%vs 69.80%)(P<0.05).Conclusion Compared with TIPS alone,its combination with GCVE can not only reduce the risk of rcblccding and death,but also not increase the risk of surgical complications,which is worthy of clinical attention.

关 键 词：食管胃底静脉曲张破裂出血 经颈静脉肝内门体分流术 胃冠状静脉栓塞术 

分 类 号：R571.3[医药卫生—消化系统] R815[医药卫生—内科学]