经皮经肝TH胶栓塞治疗胃静脉曲张的疗效分析

目的观察经皮经肝组织胶粘合剂（TH胶）栓塞治疗胃静脉曲张的临床疗效。方法经皮经肝TH胶栓塞治疗胃静脉曲张30例，术后定期复查胃镜及CT门静脉成像，观察TH胶在血管内的分布范围、血管栓塞程度及静脉曲张消失情况。结果30例患者静脉曲张治疗有效率100％。21例患者随访11—33个月，平均27．9个月，静脉曲张复发率14．29％（3／21）；术后门脉高压性胃病17例80．95％（17／21）；再出血率9．52％（2／21），均为门脉高压性胃病出血。术后CT平扫及门静脉血管成像检查显示，TH胶在胃底周围静脉、胃壁的穿支静脉及其他供血静脉内栓塞良好，TH胶持久沉积，未出现栓塞血管再通及明显新的侧枝形成。结论经皮经肝TH胶栓塞术可使胃曲张静脉及其供血静脉长期闭塞，是治疗胃曲张静脉的有效方法。

Percutaneous trans-hepatic Cyanoacrylate embolization for gastric varices

Objective To evaluate the efficacy of percutaneouse trans-hepatic Cyanoacrylate (TH glue) embolization for gastric varices. Methods TH glue was injected into the gastric varices and its feeder veins in 30 patients. The endoscopy was performed at 1 week and every 3 months after the procedure, while the CT and portal vein angiography were performed at 3 months and every 6 months after the procedure to e-valuate the oblitazation results. Results The effective rate of treatment was 100%. A total of 21 patients were followed up in a mean period of 27.9 months (11-33 months) with a recurrence rate of varices at 14. 29% (3/21). Portal hypertensive gastropathy was observed in 17 patients (80. 95%), and to-bleeding occurred in 2 patients (9. 52%) due to portal hypertensive gastropathy. CT and portal vein angiography dis-played TH glue in fundic peripheral veins, perforating veins in the gastric wall and other feeding veins with-out re-ciroulation or new branches after embolization. Conclusion Peroutaneous trans-hepatic TH glue is a-ble to embolize the gastric varices and its feeding veins, which is feasible and effective in treatment of gastric varices.