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[目的]探讨双介入治疗胃食管静脉曲张破裂出血并脾功能亢进(脾亢)的疗效。[方法]21例患者均经检查确诊为慢性乙型肝炎后肝硬化并门脉高压症,脾肿大,胃镜提示有中度至重度胃食管静脉曲张并有活动性出血。行经皮肝穿胃食管曲张静脉栓塞术(PTVE)和部分脾动脉栓塞术(PSAE),观察止血率、病死率及再出血率。[结果]21例患者均取得成功,15例出血立即停止,6例于1周内有少量出血。4例分别于术后5、8、15及20个月后再次出现胃食管静脉曲张破裂出血。[结论]双介入疗法是治疗门脉高压症胃食管静脉曲张破裂出血的有效方法,在控制急性出血、降低病死率及再出血率等方面疗效显著。
[Objective] To investigate the curative effect of double interventional treatment of gastroesophageal variceal bleeding and hypersplenism (hypersplenism). [Methods] Twenty-one patients were diagnosed as chronic posthepatitic cirrhosis and portal hypertension with splenomegaly. Gastroscopy suggested moderate to severe gastroesophageal varices with active bleeding. Percutaneous transhepatic esophageal variceal embolization (PTVE) and partial splenic arterial embolization (PSAE) were performed to observe the rate of hemostasis, mortality and rebleeding rate. [Results] All 21 patients were successful, 15 patients stopped immediately and 6 patients had a small amount of bleeding within 1 week. In 4 cases, gastroesophageal variceal bleeding again occurred at 5, 8, 15 and 20 months after operation. [Conclusion] Double interventional therapy is an effective method for the treatment of gastroesophageal variceal bleeding in patients with portal hypertension. It has significant curative effects in controlling acute bleeding, reducing mortality and rebleeding rate.