CAJ | 학술논문

目的观察肝硬化食管胃底静脉曲张破裂出血患者口服普萘洛尔联合经皮经肝组织胶栓塞治疗后的再出血发生率、静脉曲张复发率、死亡率和治疗前后门静脉压力以及并发门脉高压性胃病的发生率.方法入选患者43例,给予经皮经肝组织胶栓塞治疗,术前、术后口服普萘洛尔、并随访24月,以观察口服普萘洛尔联合经皮经肝组织胶栓塞,治疗后的再出血发生率、静脉曲张复发率、死亡率和治疗前后门静脉压力以及并发门脉高压性胃病的发生率.结果有效随访37例,期间发生出血4例(10.8%),食管胃底静脉曲张再发生3例(8.1%),死亡5例(13.5%),治疗前门静脉压力(41.5±5.6)cmH2O,治疗后门静脉压力(44.2±6.1)cmH2O,发生门脉高压性胃病29例(78.4%).结论口服普萘洛尔联合经皮经肝组织胶栓塞治疗食管胃底静脉曲张破裂出血患者的曲张静脉复发率低、再出血率低,死亡率较低,是治疗食管胃底静脉曲张的合理有效方法.
목적관찰간경화식관위저정맥곡장파렬출혈환자구복보내락이연합경피경간조직효전새치료후적재출혈발생솔、정맥곡장복발솔、사망솔화치료전후문정맥압력이급병발문맥고압성위병적발생솔.방법입선환자43례,급여경피경간조직효전새치료,술전、술후구복보내락이、병수방24월,이관찰구복보내락이연합경피경간조직효전새,치료후적재출혈발생솔、정맥곡장복발솔、사망솔화치료전후문정맥압력이급병발문맥고압성위병적발생솔.결과유효수방37례,기간발생출혈4례(10.8%),식관위저정맥곡장재발생3례(8.1%),사망5례(13.5%),치료전문정맥압력(41.5±5.6)cmH2O,치료후문정맥압력(44.2±6.1)cmH2O,발생문맥고압성위병29례(78.4%).결론구복보내락이연합경피경간조직효전새치료식관위저정맥곡장파렬출혈환자적곡장정맥복발솔저、재출혈솔저,사망솔교저,시치료식관위저정맥곡장적합리유효방법.
Objective To investigate the esophageal-variceal rebleeding,recurrence rate of variceal,mortality, changes of portal pressure and portal hypertensivegastropathy in patients with esophageal-gastric variceal bleeding who were treated by percutaneous transhepatic fixed THglue embolization and received propranolol therapy. Method Forty-three patients were treated with percutaneous transhepatic fixed THglue embolization. Meanwhile, all patients received 10mg dose of propranolol, three times ecery-day at the beginning of treatment, and the dose was increased to maximum tolerated dosegradually. All patients were followed up for 24 months. The rebleeding,recurrence rate of variceal,mortality,changes of portal pressure and portal hypertensivegastropathy were observed and analyzed. Result Thirty-seven cases were effectly followed-up.Bleeding occurred in four patient(10.8%).Recurrence of esophageal varices happened in 3 cases (8.1%).Tive patients died (13.5%). The portal pressure before and post treatment were (41.5±5.6) cmH2O versus (44.2±6.1) cmH2O. Thegastropathy assotiated with portal hypertension occurred in 29 cases (78.4%). Conclusion Percutaneous transhepatic fixed THglue embolization,combined with oral administration of propranolol,is a reasonable and effective way to treat patients of esophageal variceal bleeding. The rate of rebleeding,the recurrence of variceal and the mortality were very low. The portal pressure before and post treatment were of no significant difference.