CAJ | 학술논문

目的：观察多种介入方法联合应用治疗食管胃底静脉曲张的临床效果。方法：25例食管胃底静脉曲张患者，分别行经皮肝穿冠状静脉栓塞（PTVE）和球囊阻断静脉逆行硬化闭塞胃静脉曲张（BRTO），并发脾功能亢进者，同时行部分脾动脉栓塞（PSE）。术后对有残留食管静脉曲张的病例行内镜硬化剂注射治疗（EIS）。全部治疗完成后常规临床观察，并定期复查胃镜和CT增强扫描。结果：25例患者，7例行PTVE＋PSE；11例行BRTO，6例行BRTO＋PSE，1例BRTO手术失败；术后11例患者接受内镜注射治疗一次，4例患者接受二次注射治疗。3例患者死亡，其中1例于术后2月死于再发出血。结论：多种介入方法联合应用，具有可靠的预防上消化道出血的效果。
목적：관찰다충개입방법연합응용치료식관위저정맥곡장적림상효과。방법：25례식관위저정맥곡장환자，분별행경피간천관상정맥전새（PTVE）화구낭조단정맥역행경화폐새위정맥곡장（BRTO），병발비공능항진자，동시행부분비동맥전새（PSE）。술후대유잔류식관정맥곡장적병례행내경경화제주사치료（EIS）。전부치료완성후상규림상관찰，병정기복사위경화CT증강소묘。결과：25례환자，7례행PTVE＋PSE；11례행BRTO，6례행BRTO＋PSE，1례BRTO수술실패；술후11례환자접수내경주사치료일차，4례환자접수이차주사치료。3례환자사망，기중1례우술후2월사우재발출혈。결론：다충개입방법연합응용，구유가고적예방상소화도출혈적효과。
Objective:To evaluate the clinical efficacy of esophagogastric varices treatment with various interventional approaches in combination.Methods:For 25 patients with esophagogastric varices,percutaneous transhepatis variceal embo-lization (PTVE)or balloon-occluded retrograde transvenous obliteration (BRTO)was performed respectively.Partial splen-ic artery emoblization was performed simultaneously in patients accompanied with hypersplenia.Sclerotherapy via endoscopy (EIS)was used in patients with remained esophageal varices during follow-up.Clinical follow-up endoscopy and enhanced CT were performed routinely in patients having all treatments accomplished.Results:Of the 25 patients,PTVE+PSE were performed in 7 cases,BRTO in 11 cases,and BRTO+PSE in 6 cases.BRTO failed in one case.Sclerotherapy via endoscopy injection was performed once for 11 patients with remained esophagogastric varices after primary treatment,it was per-formed twice for 4 patients.Three patients died,one of them due to recurrent bleeding 2 months after treatment.Conclu-sions:Various interventional approaches in combination has reliable efficacy in preventing recurrent bleeding of esophagogas-tric varices .