CAJ | 학술논문

目的评价经脾入路栓塞治疗门静脉高压上消化道出血的临床疗效及安全性.方法 20例乙型肝炎后肝硬化患者,均出现门静脉高压性食管胃底静脉曲张破裂出血.8例为右叶巨大肝癌;10例为肝癌合并门静脉癌栓,门静脉主干闭塞;2例为肝硬化并发门静脉主干血栓性闭塞.所有患者采取经脾穿刺,脾静脉插管至胃冠状静脉,用液态栓塞剂加弹簧圈栓塞曲张的食管胃底静脉.结果 18例患者手术成功,2例失败;共栓塞35支胃冠状静脉,栓塞成功患者均获有效止血,未出现并发症.结论经脾穿刺插管栓塞治疗门静脉高压上消化道出血的方法安全有效,适合于患有巨大肝癌及(或)门静脉主干闭塞等无法采用经皮经肝入路或TIPS栓塞食管胃底静脉曲张的患者.
목적 평개경비입로전새치료문정맥고압상소화도출혈적림상료효급안전성.방법 20례을형간염후간경화환자,균출현문정맥고압성식관위저정맥곡장파렬출혈.8례위우협거대간암;10례위간암합병문정맥암전,문정맥주간폐새;2례위간경화병발문정맥주간혈전성폐새.소유환자채취경비천자,비정맥삽관지위관상정맥,용액태전새제가탄황권전새곡장적식관위저정맥.결과 18례환자수술성공,2례실패;공전새35지위관상정맥,전새성공환자균획유효지혈,미출현병발증.결론 경비천자삽관전새치료문정맥고압상소화도출혈적방법안전유효,괄합우환유거대간암급(혹)문정맥주간폐새등무법채용경피경간입로혹TIPS전새식관위저정맥곡장적환자.
Objective To investigate the value of percutaneous transsplenic varices embolization (PTSVE) for treatment of upper gastrointestinal bleeding. Methods Twenty cases with liver cirrhosis and portal hypertension suffered upper gastrointestinal bleeding. PTSVE was administered to them with hardener and coils. Among them, 8 cases had massive hepatocellular carcinoma (HCC) in right lobe; 10 cases with hepatocellular carcinoma had portal vein tumor thrombus and occlusion; the other two cases with liver cirrhosis had portal vein thrombosis. All of these cases were not suitable for percutaneous transhepatic varices embolization (PTHVE) . PTSVE was performed under the guidance of fluoroscopy. Results Technical success was achieved in 18 patients. A total of 35 gastric coronary veins were embolized. In all these cases, upper gastrointestinal bleeding stopped after PTSVE. There was no recurrence within 1 month follow-up. No serious complication occurred. Conclusion PTSVE is a safe and efficient alternative treatment for upper gastrointestinal bleeding, especially for cases with portal vein occlusion or with massive HCC in right lobe of liver.