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目的 探讨经皮穿肝及穿脾治疗门静脉高压胃食管曲张静脉破裂出血的可行性和疗效。方法 对19例病人行经皮穿肝胃冠状静脉栓塞术 ,对 12例病人行经皮穿脾胃冠状静脉栓塞术。结果 所有病人手术成功。随访 3～ 2 6个月 ,再出血 3例 ,其中 6个月内再出血 1例 ;死亡 6例 ,其中 1例死亡原因为上消化道出血 ,5例为肝功能衰竭。结论 该手术是治疗门静脉高压胃底食管曲张静脉破裂出血的有效方法。对于肝占位病变及门静脉癌栓等不宜行经皮穿肝门静脉插管的病人 ,经皮穿脾门静脉插管可作为一种安全的替代方法
Objective To investigate the feasibility and efficacy of percutaneous transhepatic and transplexive splenectomy in the treatment of portal hypertensive gastroduodenal variceal bleeding. Methods Twenty-nine patients underwent percutaneous transhepatic coronary vein thrombolysis and 12 patients underwent percutaneous coronary intervention. Results All patients were successfully surgically treated. All the patients were followed up for 3 ~ 26 months. There were 3 cases of rebleeding, 1 case of rebleeding within 6 months and 6 cases of death. Among them, 1 died of upper gastrointestinal bleeding and 5 cases of liver failure. Conclusion This procedure is an effective method for the treatment of portal hypertensive gastroduodenal variceal bleeding. For liver space lesions and portal vein tumor thrombus should not be percutaneous transhepatic portal vein catheterization, percutaneous transvenous portal vein catheterization can be used as a safe alternative