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目的 比较单纯性经颈内静脉肝内门体分流术(TIPS)和TIPS联合胃冠状静脉栓塞术(GCVE)急诊治疗门静脉高压症(PHT)伴上消化道出血的安全性及临床疗效.方法 PHT伴上消化道大出血病人76例,其中单纯性TIPS组35例,行单纯性TIPS治疗,TIPS联合GCVE组41例,行TIPS联合GCVE治疗,比较两组病人手术前后门静脉直径、门静脉压力、食管胃底静脉曲张程度、急诊止血率、再出血率、并发症发生率.结果 与单纯性TIPS治疗相比,TIPS联合GCVE治疗明显提高病人急诊止血率(82.9%和100%,P<0.05),改善食管胃底静脉曲张程度(P<0.05)及降低再出血率(17.6%和7.5%,P0.05).结论 TIPS联合GCVE治疗PHT伴上消化道出血疗效确切,特别是在急诊止血率、再发出血率及改善静脉曲张程度方面明显优于单纯性TIPS治疗.“,”Objective To compare the security and clinical effects between transjugular intrahe-patic portosystemic stent-shunt(TIPS)and TIPS combines with gastric coronary vein embolization (GCVE)in treatment of portal hypertension(PHT)complicated with upper gastrointestinal hemorrhage. Methods Retrospective analysis was conducted on the clinical data or 76 patients with PHT complicated with upper gastrointestinal hemorrhage.35 patients were for only TIPS treatment and 41 patients were for TIPS plus GCVE treatment.The data of diameter and vein pressure of portal vein,the degree of gastroe-sophageal varices,the rate of emergency hemostasis,recurrent bleeding and complication were collected and analyzed.Results Compared with the TIPS treatment,TIPS combines with GCVE treatment signifi-cantly increased the rate of emergency hemostasis(82.9% vs.100%,P<0.05),improved the degree of gastroesophageal varices(P<0.05)and decreased the rate of recurrent bleeding(17.6% vs.7.5%,P0.05).Conclusion TIPS combined with gas-tric coronary vein embolization is a safe and effective surgical procedure,the roles of this treatment in e-mergency hemostasis,improving the degree of gastroesophageal varices and recurrent bleeding are superior to the only TIPS treatment.