CAJ | 학술논문

目的评价以医用胶为栓塞剂的经皮经肝胃底曲张静脉栓塞术(PTVE)治疗和预防肝硬化患者瘤样胃底静脉曲张破裂出血的临床疗效.方法回顾性分析24例采用医用TH胶完成PTVE治疗的肝硬化胃底静脉曲张破裂出血患者的病例资料,比较治疗前后胃底静脉曲张程度的变化情况,统计术后再出血率及死亡率.结果治疗前24例患者胃底曲张静脉团直径均在20 mm以上,治疗后胃底静脉曲张程度显著减轻,其中20例(83.3％)曲张静脉团直径减至5 mm以下或消失,4例(16.7％)曲张静脉团直径减至5 ～10 mm.在术后1～36个月,平均16.6个月的随访期内,再出血率和病死率分别为12.5％和12.5％,其中l例死于肝癌,另外2例死于慢性肝功能衰竭.结论对于肝硬化瘤样胃底静脉曲张破裂出血的患者,行医用胶为栓塞剂的PTVE治疗具有良好的临床效果.
목적 평개이의용효위전새제적경피경간위저곡장정맥전새술(PTVE)치료화예방간경화환자류양위저정맥곡장파렬출혈적림상료효.방법 회고성분석24례채용의용TH효완성PTVE치료적간경화위저정맥곡장파렬출혈환자적병례자료,비교치료전후위저정맥곡장정도적변화정황,통계술후재출혈솔급사망솔.결과 치료전24례환자위저곡장정맥단직경균재20 mm이상,치료후위저정맥곡장정도현저감경,기중20례(83.3％)곡장정맥단직경감지5 mm이하혹소실,4례(16.7％)곡장정맥단직경감지5 ～10 mm.재술후1～36개월,평균16.6개월적수방기내,재출혈솔화병사솔분별위12.5％화12.5％,기중l례사우간암,령외2례사우만성간공능쇠갈.결론 대우간경화류양위저정맥곡장파렬출혈적환자,행의용효위전새제적PTVE치료구유량호적림상효과.
Objective To investigate the efficacy of percutaneous transhepatic variceal embolization (PTVE) with Cyanoacrylate (TH glue) in treating large gastric fundal variceal bleeding.Methods PTVE was performed on 24 patients with TH glue injected into the main stem of left gastric vein and its fundic branches.The degree of varices in gastric fundus,rebleeding rate and survival rate after the procedure were compared with those before.Results Varices in gastric fundus were all embolized successfully with TH glue.The diameter of varices was reduced to below 5mm or disappeared in 20 patients (83.3％),and reduced to 5-10mm in the other 4 ( 16.7％ ) During the follow-up period of 3-36 months(mean 16.6 months),the rebleeding rate and mortality were 12.5 ％ ( 3/24 ),and 12.5 ％ (3/24),respectively.One patient died of liver cancer,and two others died of chronic liver failure.Conclusion PTVE with TH glue is of ideal therapeutic effect to block the feeding veins of large gastric fundal varices.