部分性脾动脉栓塞联合内镜下套扎治疗肝硬化食管静脉曲张破裂出血的临床分析

目的探讨部分性脾动脉栓塞术联合经内镜套扎术治疗肝硬化脾功能亢进食管静脉曲张破裂出血的临床价值。方法对30例肝硬化门脉高压脾功能亢进的患者,胃镜下行曲张静脉套扎术,术后行部分性脾动脉栓塞术,术后观察近期止血效果和远期再出血发生率及外周血细胞等变化。结果部分性脾动脉栓塞术联合内镜套扎术近期止血效果显著(100%),食管-胃底曲张静脉消失率达83.3%;无手术死亡病例,无严重并发症,远期出血率为6.7%。外周血细胞及血小板均较术前明显回升。结论部分性脾动脉栓塞术联合内镜套扎术治疗肝硬化脾功能亢进食管静脉曲张破裂出血具有简便、安全、有效、创伤小、并发症少等优点,值得在临床推广应用。

Value of combined partial splenic artery embolization and endoscopic variceal ligation in liver cirrhosis,hypersplenism and esophageal varices bleeding

Objective To determine the value of combined partial splenic artery embolization and endoscopic variceal ligation on patients with liver cirrhosis, hypersplenism and esophageal varices rupture （PSE-EVL） Methods PSE-EVL was performed on 30 patients withlivercirrhosis, hypersplenismandesophagealvaricesmpture. Short-term hemostasis and long-term recurrent bleeding were recorded. Results Short-term hemostasis of PSE-EVL was obtained in all patients. Esophageal and gastric fundal varicose veins were obliterated in 83.3% of patients. There was no serious complication or operative death. Of the 30 patients, long-term recurrent bleeding occurred in 6.67%. The levels of peripheral red and white blood cells and platelets increased post-operatively. Conclusion PSE-EVL is a simple, safe, effective treatment with few complications for patients with liver cirrhosis, hypersplenism and esophageal varices rupture.