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目的评价经皮经肝食管胃底静脉曲张栓塞术(PTO)的临床疗效及应用价值。方法肝硬化门静脉高压合并食管胃底静脉曲张破裂出血患者43例,其中17例因急性上消化道出血行急症止血治疗,16例为消化道出血停止后择期栓塞,10例肝硬化伴重度食管胃底静脉曲张行预防性治疗。以明胶海绵,无水乙醇和弹簧钢圈为栓塞剂栓塞食管胃底静脉。结果43例食管胃底曲张静脉患者超选择插管,栓塞全部成功。17例急性上消化道出血患者术后均止血成功,其中1例急诊患者因全身状况差,术后第7天再次出血死亡。28例患者术后胃镜复查显示胃底曲张静脉完全消失者22例,明显改善者6例,30例患者术后得到随访,随访4～36个月,再出血5例,死亡2例。结论经皮经肝食管胃底静脉曲张栓塞术创伤小、操作安全、疗效确切,值得推广应用。
Objective To evaluate the clinical efficacy and clinical value of percutaneous transhepatic esophageal varices embolization (PTO). Methods Forty-three patients with cirrhosis complicated with esophageal and gastric variceal hemorrhage were enrolled, of whom 17 were treated by acute upper gastrointestinal hemorrhage and emergency treatment, 16 were elective embolization after gastrointestinal bleeding stopped, 10 were cirrhosis with severe esophageal Prophylaxis of varicose vein. Gelatin sponge, ethanol and spring steel ring embolization of esophageal and gastric fundus. Results 43 cases of esophageal varices were surgically selected and successfully embolized. Seventeen patients with acute upper gastrointestinal hemorrhage were successfully treated with hemostasis. One of the emergency patients died due to poor general condition and re-bleeding on the seventh postoperative day. Twenty-eight patients underwent gastroscopy showed that 22 cases of complete disappearance of gastric varicose veins disappeared in 6 cases. 30 cases were followed up for 4 to 36 months, 5 cases were rebleeding and 2 cases died. Conclusion Percutaneous transhepatic esophagogastric varices embolization is safe, safe and effective. It is worth popularizing and applying.