PTVE联合PSE双介入治疗肝硬化并门脉高压、脾功能亢进

目的:观察经皮经肝胃冠状静脉栓塞术(percutaneous transhepatic variceal embolization,PTVE)联合部分脾栓塞术(partial splenic embolization,PSE)的双介入栓塞术治疗肝硬化并门脉高压及脾功能亢进的临床疗效。方法:10例肝硬化并门脉高压、脾功能亢进患者,给予PTVE治疗预防出血,3～7 d后,再行PSE降低门脉压及改善脾功能亢进。随访3月,观察止血率、再出血率、血象、肝功能、胃镜及并发症等指标。结果:10例患者中8例完成栓塞治疗及后续PSE治疗,2例急性出血患者迅速止血。随访3月,全部病例肝功能改善、血细胞回升至正常水平,无再出血和严重并发症发生。其中3例胃镜复查显示2例食管胃底静脉曲张均减轻,1例消失。结论:PTVE联合PSE的双介入栓塞术治疗肝硬化并门脉高压及脾功能亢进疗效确切,安全性好,值得临床推广。

PTVE Combined PSE in Treatment of Patients with Liver Cirrhosis Complicated Portal Hypertension and Hypersplenism

Objective To evaluate the efficacy of percutaneous transhepatic variceal embolization(PTVE) combined partial splenic embolization(PSE) for treatment of patients with liver cirrhosis complicated portal hypertension and hypersplenism.Methods Ten patients with liver cirrhosis complicated portal hypertension and hypersplenism were treated by PTVE,followed by PSE at 3 to 7 days later.The all patients were followed-up for 3 months to record the hemostatic rate,rebleeding rate,hemogram,liver function,endoscope examination and complications.Results Eight cases of the ten patients were successfully treated by PTVE combined PSE.Active bleeding was controlled in 2 cases of patients with acute hemorrhage.The liver function and hemogram were improved in all patients without rebleeding and severe complications.The following endoscopy were carried out in three patients demonstrated that the esophageal and gastric varices were eliminated partially in two cases and disappeared completely in one case.Conclusion The combination therapy of PTVE and PSE is effective and safe in treatment of patients with liver cirrhosis complicated portal hypertension and hypersplenism.