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目的 探讨经皮穿肝及穿脾治疗门静脉高压胃食管曲张静脉破裂出血的可行性和疗效。方法 对19例病人行经皮穿肝胃冠状静脉栓塞术,对12例病人行经皮穿脾胃冠状静脉栓塞术。结果 所有病人手术成功。随访3－26个月,再出血3例,其中6个月内再出血1例;死亡6例,其中1例死亡原因为上消化道出血,5例为肝功能衰竭。结论 该手术是治疗门静脉高压胃底食管曲张静脉破裂出血的有效方法。对于肝占位病变及门静脉癌全等不宜行经皮穿肝门静脉插管的病人,经皮穿脾门静脉插管可作为一种安全的替代方法。

Clinical application of gastroesophageal varices embolization in portal hypertension.

Objective To investigate the feasibility and efficacy of percutaneous transhepatic or transsplenic embolization of gastroesophageal varices in gastroesophageal varices.Methods Percutaneous transhepatic embolization of gastroesophageal varices was performed in 19 cases and percutaneous transsplenic embolization of gastroesophageal varices was performed in 12 cases.Results All procedures were successfully done in 31 cases.Variceal bleeding recurred in three cases from 3 to 26 months after embolization.One of them rebled in 6 months after embolization.6 cases died,one of them died of rebleeding,5 of hepatic function failure.Conclusion Transhepatic embolization is a safe,easy-to-perform,and effective treatment for the control of variceal bleeding.Transsplenic portal catheterization is an alternative of transheptic portal catheterization in case with portal occlusion.