| 应用NBCA栓塞治疗食管胃底静脉曲张的临床疗效 |
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| 引用本文： | 朱康顺,李征然,何可可,庞鹏飞,关守海,姜在波,黄明声,单鸿. 应用NBCA栓塞治疗食管胃底静脉曲张的临床疗效[J]. 中国医学影像技术, 2006, 22(12): 1866-1869 |
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| 作者姓名： | 朱康顺 李征然 何可可 庞鹏飞 关守海 姜在波 黄明声 单鸿 |
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| 作者单位： | 中山大学附属第三医院放射科,广东,广州,510630 |
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| 基金项目： | 广东省科技计划项目资助(2004B35001007)。 |
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| 摘 要： | 目的探讨应用NBCA栓塞治疗门静脉高压症食管胃底静脉曲张的临床疗效。方法肝硬化门静脉高压症合并食管胃底静脉曲张患者28例,其中9例为肝癌合并门静脉癌栓。28例中,15例为食管静脉套扎术后再出血者,13例为药物保守治疗后再出血者。28例患者采取经皮经肝或经脾穿刺门静脉造影及曲张静脉的栓塞治疗,栓塞材料为组织黏合剂正丁基-2-氰丙烯酸盐(NBCA),NBCA和超液化碘化油的比例为1∶4~1∶8。对有较大的胃肾分流者,栓塞前经右股静脉、左肾静脉入路,放置球囊导管于分流道,栓塞时球囊扩张阻塞分流道。所有患者栓塞前后进行门静脉压力测定。结果28例中,27例成功进行胃左静脉、胃后静脉和胃短静脉完全性栓塞,其中8例较大胃肾分流者,栓塞时应用了阻塞球囊技术。门静脉压力由术前(34.7±7.4)cmH2O上升至术后(38.7±4.4)cmH2O(P<0.05)。4例见少量栓塞剂进入末梢肺动脉,2例出现一过性刺激性咳嗽,无严重的肺栓塞发生。11例患者术后胃镜复查,均显示静脉曲张明显改善。14例患者术后CT增强复查,均显示栓塞的曲张静脉仍完全闭塞,其中3例可见静脉侧支形成。28例患者,随访3~26个月,平均(9.9±6.7)个月,再出血5例(17.9%)。结论应用NBCA栓塞治疗食管胃底静脉曲张,安全可行,止血效果肯定;但对有较大的胃肾分流者,逆行球囊阻塞分流道是必要的,可防止肺栓塞发生。
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| 关 键 词： | 门静脉高压 静脉曲张 食管胃底静脉 栓塞 治疗性 |
| 文章编号： | 1003-3289（2006）12-1866-04 |
| 收稿时间： | 2006-09-16 |
| 修稿时间： | 2006-11-22 |
Clinical efficacy of embolization with NBCA for esophageal-gastric fundal varices in portal hypertension |
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| ZHU Kang-shun,LI Zheng-ran,HE Ke-ke,PANG Peng-fei,GUAN Shou-hai,JIANG Zai-bo,HUANG Ming-sheng and SHAN Hong. Clinical efficacy of embolization with NBCA for esophageal-gastric fundal varices in portal hypertension[J]. Chinese Journal of Medical Imaging Technology, 2006, 22(12): 1866-1869 |
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| Authors: | ZHU Kang-shun LI Zheng-ran HE Ke-ke PANG Peng-fei GUAN Shou-hai JIANG Zai-bo HUANG Ming-sheng SHAN Hong |
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| Affiliation: | Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China;Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China |
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| Abstract: | |
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| Keywords: | Portal hypertension Varices esophageal-gastric fundal vein Embolization therapeutic |
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