胃冠状静脉栓塞术治疗门脉高压食管胃底静脉曲张出血的疗效分析

目的探讨应用胃冠状静脉栓塞术治疗门静脉高压食管胃底静脉曲张出血的疗效。方法回顾分析1998年7月—2004年2月间,42例门脉高压症患者(栓塞组)行胃冠状静脉栓塞术治疗门静脉高压食管胃底静脉曲张出血的疗效,并与20例同期仅行贲门周围血管离断术(对照组)的疗效进行比较,分别观察食管及胃底静脉曲张的消除率、再出血率及手术死亡率。结果术后平均随访23.5月,栓塞组再出血率为0,对照组再出血率为25%。两组患者均无死亡。结论胃冠状静脉栓塞术是安全、可靠的,可使贲门周围血管阻断更为彻底,降低复发,从而进一步提高周围血管离断的疗效。

Embolization Therapy of Coronary Vein of Stomach in the Management of Variceal Bleeding in Portal Hypertension

Objective To investigate the therapeutic effect of embolization therapy of coronary vein of the stomach in the management of variceal bleeding in portal hypertension.Methods From Jul. 1998 to Feb. 2004, 42 portal hypertensive patients were treated with embolization therapy of coronary vein of the stomach, and 20 patients with upper GI bleeding due to portal hypertension who received only pericardial devascularization were enrolled as controls. The eliminating rate of varicose vein and the rebleeding rate were evaluated. Results All the patients were followed up for a mean time of 23.5 months. No patient in the study group had upper GI re-bleeding during the 23.5 months' follow-up. The re-bleeding rate in the control group was 25%, and none suffered re-bleeding in the study group. The cure rate of varicose vein was 100% in the study group and 50.0% (10/20) in the control group (P<0.01). Conclusion The therapeutic effect of pericardial devascularization could be improved by using embolization therapy of conroary vein of the stomach.