内镜静脉套扎与部分性脾栓塞联合治疗肝硬化门脉高压

目的:探讨内镜静脉套扎(EVL)和部分性脾栓塞(PSE)联合治疗肝硬化门脉高压症的效果。材料和方法:13例肝硬化门脉高压症的患者行EVL与PSE联合治疗,记录EVL及PSE实施情况,比较治疗前后临床症状、肝脏功能、外周血细胞计数及脾脏大小的变化,观察术后不良反应及严重并发症。结果:EVL平均次数1.5次,除1例(首次联合术后9个月因脾亢复发行第二次PSE)外,所有患者均行1次PSE治疗。联合治疗后消化道出血、腹胀症状明显改善,腹水减少或消失,肝功能部分恢复,外周血血小板和白细胞计数明显升高(P<0.05),脾脏体积缩小。除1例患者术后消化道出血死亡,余无严重并发症出现。结论:EVL联合PSE方法简单、安全,对肝硬化所致的门脉高压症近期疗效确切。

Combined endoscopic variceal ligation and partial splenic embolization to treat cirrhotic portal hypertension

Objective: To evaluate the efficacy of endoscopic variceal ligation(EVL) combined with partial splenic emboliza-tion(PSE) in the treatment of cirrhotic patients with portal hypertension. Materials and Methods: Thirteen cirrhotic patients with portal hypertension underwent EVL-PSE therapy. The sessions of EVL and PSE were recorded. Before and after operation, conditions including clinical symptoms, hepatic function, peripheral blood cell counts and splenic volume were compared. Complications were also observed after operation. Results: The mean session of EVL was 1.5 and all but one patient underwent PSE only once. After the combined therapy, no rebleeding occurred. Patients showed a good response on hypersplenism, congestion of alimentary tract, ascites, hepatic function, peripheral blood cell counts and splenic volume. Except one patient died of upper alimentary tract bleeding, no other serious complication due to EVL-PSE therapy was found. Conclusion: The combination of EVL and PSE is safe and simple. Its recent curative effect on portal hypertension due to cirrhosis is definite.