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双介入法治疗肝硬化并上消化道出血及脾亢的临床意义 总被引:4,自引:0,他引:4
目的 探讨经皮经肝行胃冠状静脉、胃短静脉栓塞和部分脾动脉栓塞术 (简称双介入法 ) ,治疗肝硬化合并上消化道出血、脾功能亢进的临床意义。方法 对具有完整临床诊断资料的 18例肝硬化合并急性或反复上消化道出血及脾功能亢进的病人 ,采取双介入法用无水酒精、弹簧钢圈、明胶海绵进行胃冠状静脉、胃短静脉及部分脾动脉栓塞 ,其中栓塞胃冠状静脉 18支、胃短静脉 11支 ,脾实质栓塞 5 0 %~ 70 %左右。结果 18例双介入法手术均顺利完成 ,除栓塞后均有不同程度的发热和脾区疼痛持续 1周~ 1月左右外 ,无特殊并发症发生。术后随访最长 6年 ,最短 4个月 ,18例病人均无再发消化道出血 ,脾功能亢进症状全部改善。结论 双介入法治疗肝硬化合并上消化道出血、脾功能亢进 ,手术操作简便易行 ,临床效果满意 ,值得推广 相似文献
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脾动脉栓塞术(purtial splcuic Embolization简称PSE)是一种非手术治疗的介入放射学新技术,临床用于治疗各种病因所致的脾脏肿大并发脾功能亢进具有外科学术指征的患者。我科自1998年至今,采用PSE治疗病人26例,经过严密观察及护理取得满意的疗效,现将PSE疗法及临床护理介绍如下。 相似文献
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部分脾动脉栓塞能抑制亢进的脾功能和减少肿大脾的体积,且能保留部分脾组织及功能。近年来,我中心共行部分脾动脉栓塞治疗脾亢15例,取得较满意的治疗效果,现将脾动脉栓塞的护理要点介绍于下。一、资料本组15例,男11例,女4例。平均年龄54(5~70)岁,其... 相似文献
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目的:研究脾动脉部分栓塞在肝癌介入治疗中的临床应用价值。方法:对62例肝癌病人在肝动脉灌注化疗栓塞过程中进行脾动脉部分栓塞治疗,观察病人血液中自细胞、血小板计数及肝功能的变化,判断疗效。结果:治疗后所有病人白细胞、血小板计数升高,恢复正常的时间为术后2—4周,49例肝功能改善,原有牙龈出血和鼻衄等症状大多消失,伴门脉癌栓76%(16/21)术后近期腹水减少或消失,肝功能恢复较快,无严重并发症。结论:肝癌介入化疗栓塞同时行脾动脉部分栓塞可以有效改善肝功能,缓解脾功能亢进,促进血液中自细胞、血小板升高,减轻门脉压力增高,提高免疫力,对肝癌预后有积极作用。 相似文献
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脾功能亢进行脾动脉栓塞其原理是部分性脾动脉栓塞,致使被拴塞的部分脾脏失去血供,导致液化坏死;同时保存一部分脾脏的完整性,使其完成免疫功能。改善了外周血象,使患者临床症状明显改善。故在治疗脾功能亢进时介入栓塞方法成为外科脾切除的替代疗法,也是脾功能亢进首先的治疗方法。但在实际工作中,由于脾动脉栓塞,脾液化坏死,在临床上会出现一系列并发症;我院在20(~--2005年间,共为35例患者行动脉栓塞术,术后出现的各种并发症总结归纳如下,仅共在临床介入工作的同仁参考。 相似文献
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部分性脾栓塞术不同栓塞方法的对比研究 总被引:1,自引:0,他引:1
目的探寻脾亢患者部分性脾栓塞(PSE)术较为合适的栓塞方法。方法78例脾亢患者中32例为脾动脉主干内PSE术(主干组),46例为脾动脉分干内PSE术(分干组)。所有患者术后观察并发症情况,第15d、30d、60d、90d分别复查白细胞和血小板计数,并与术前比较,以此评价PSE术的疗效。然后对主干组和分干组结果进行对比分析。结果78例患者术后均无严重并发症,脾外栓塞及呼吸系统并发症分干组较主干组轻而少。术后白细胞和血小板计数,第15天时主干组和分干组比较差异均无显著性意义(P>0.05);第30天时二者比较差异均有显著性意义(P<0.05);第60天、90天时二者比较差异则均有非常显著性意义(P<0.001)。结论对于脾亢患者,脾动脉分支若呈二干型或三干型,则应尽量行分干内PSE术;分支若呈无干型或主干明显扭曲而插管困难时,则宜行主干内PSE术。 相似文献
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Jaime Tisnado M.D. Michael C. Beachley Shao-Ru Cho Scott S. Coyne 《Cardiovascular and interventional radiology》1980,3(3):187-189
Massive perineal bleeding due to trauma was successfully controlled by superselective embolization of the internal pudendal
artery with a stainless steel mini coil. While in the standard selective procedure the internal iliac artery is embolized,
the superselective technique allows preservation of the blood supply from the uninjured branches of the internal iliac artery. 相似文献
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William M. Thompson M.D. Irwin S. Johnsrude 《Cardiovascular and interventional radiology》1980,3(4):244-253
Transcatheter intravascular electrocoagulation for therapeutic occlusion of vessels has been experimentally developed and
successfully used clinically as an alternative to, and in conjunction with, more routine methods of vessel occlusion. A constant
current power source and a steelguide wire anode are used for the occlusion. The subject is grounded with a standard bovie
plate insulated from the skin by a highly lubricated sponge. Permanent occlusion of strategic vessels at accurately controlled
sites has been achieved with little risk of embolization of non-target areas. There has been minimal damage to vessel walls,
and complete occlusion has been possible despite heparinization and/or thrombocytopenia. One limitation is the inconstant
ability to position the anode precisely at the desired site of occlusion. Also, a long time may be required (up to one hour)
to occlude larger vessels with presently available anodes. Wider use must await refinements in development of the anode material
and in its delivery system. 相似文献
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丝线加明胶海绵脾脏栓塞治疗脾功能亢进 总被引:14,自引:0,他引:14
目的 探讨部分脾栓塞(PSE) 治疗脾功能亢进( 脾亢) 的临床应用价值,寻找理想的栓塞剂及合理使用方法,以提高脾栓塞疗效。方法 将40 例肝硬化脾亢患者随机分为两组:治疗组30 例,用真丝线段加明胶海绵双重栓塞;对照组10 例,单用明胶海绵栓塞。栓塞面积控制在50% ~70 % 。结果 治疗组30 例,获CR19 例(63 %) ,PR7 例(23% ) ,总有效率86% 。1 年复发率32% 。对照组10例,获CR6 例(60 % ),PR2 例(20 % ),总有效率80% 。1 年复发率66% 。结论 脾亢患者丝线加明胶海绵双重栓塞,其疗效优于单用明胶海绵。两者近期效果无显著性差异( P> 0.05),但1 年复发率前者明显低于后者( P<0 .05)。 相似文献
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Embolization of a thoracic aortic aneurysm; The straddling coil technique: Technical note 总被引:1,自引:0,他引:1
Hiromu Mori M.D. Toshio Fukuda Yutaka Ishida Nobuyuki Hayashi Kuniaki Hayashi Hirofumi Maeda 《Cardiovascular and interventional radiology》1990,13(1):50-52
Occlusion of a patent postligated aortic aneurysymwas performed percutaneously with modified use of giant steel coils in a
50-year-old man. Steel coils were placed across the short, narrowed segment of the aorta. Successful thrombosis of entire
aortic aneurysm was accomplished. No complications occurred. 相似文献
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Postoperative retroperitoneal hemorrhage due to a bleeding ureteric artery: treatment by transcatheter embolization 总被引:4,自引:0,他引:4
We report a case of a postoperative retroperitoneal haemorrhage due to an iatrogenic perioperative injury of an ureteric
artery. Transcatheter embolization using microparticles stopped the bleeding and the patient stabilized immediately. Ureteric
artery injury is a very rare condition but can be managed successfully by percutaneous interventional techniques.
Received: 15 October 1999 Revised: 10 April 2000 Accepted: 14 April 2000 相似文献
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Topi M. J. Siniluoto M.D. Pekka A. Hellström Markku J. Päivänsalo Aaro S. S. Leinonen 《Cardiovascular and interventional radiology》1988,11(3):162-164
A case of infarction of the left testis secondary to transcatheter embolization of a malignant left renal tumor with absolute
ethanol is presented. The mechanism producing this complication was due to the anomalous nature of the left testicular artery,
originating from the left renal artery distal to the site of the balloon occlusion catheter. The importance of this anomaly
is discussed and the literature reviewed. 相似文献
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Arthur C. Waltman M.D. 《Cardiovascular and interventional radiology》1980,3(4):289-295
The transcatheter method appropriate for use in the control of arteriocapillary gastrointestinal bleeding is a point of controversy.
Intraarterial vasopressin infusion, which has been performed in more than 500 patients at the Massachusetts General Hospital,
has achieved control in 90% of patients actively bleeding from the stomach and colon. In view of the severity of hemorrhage
and associated illnesses in these patients, the complication rate associated with this method was low. Intraarterial vasopressin
infusions were ineffective in pyloroduodenal and postoperative bleeding sites and hemorrhage from abscesses. While embolization
can control bleeding in these areas, complications have been shown despite precise selective catheter placement. Because of
catheterization difficulties and the permanency of the vascular occlusion, embolization is reserved for patients in whom surgical
intervention would be associated with extreme risks. 相似文献
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Transcatheter obliteration of the renal artery by ethanol injection: Experimental results 总被引:1,自引:0,他引:1
Leif Ekelund M.D. Nils Jonsson Hendrik Treugut 《Cardiovascular and interventional radiology》1981,4(1):1-7
The sclerosing effect of the introduction of 95% ethanol into the renal artery was evaluated in eight rabbits and one pig.
Longtern occlusio of the renal artery with ensuing infarction of the kidney could be produced by a small, easily tolerated
dose. Several inherent drawbacks of currently used embolic agents may be avoided with this technique, which is suggested for
clinical trial. 相似文献
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目的:探讨对肝硬化脾功能亢进患者行不同程度栓塞后的临床疗效。方法:选择43例肝炎后肝硬化脾功能亢进患者。A组17例,栓塞面积约40%~50%;B组26例,栓塞面积约70%~80%。采用Seldinger技术经右侧股动脉插管到脾动脉脾门处或脾中下极动脉用PVA微粒行部分脾动脉栓塞。并于术后3d、1周、2周、1个月、3个月、6个月、1年及两年复查血常规,以此评价两种不同栓塞程度治疗的效果。结果:术后白细胞、血小板均上升。B组的疗效优于A组,并有统计学意义。结论:部分脾动脉栓塞面积在70%~80%疗效较好,在病情允许下应加大栓塞面积,以稳定疗效。 相似文献
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