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内镜下食管静脉曲张套扎术联合部分脾栓塞术治疗门静脉高压症

[Treatment of portal hypertension by endoscopic esophageal ligation of varicose veins combined with partial splenic embolization].

作者信息

Liu Bo, Xu Rui-yun, Qiu Wan-shou, Lin Nan, Chen Tu-feng, Huang Fei-zhou, Liu Xun-yang

机构信息

Department of General Surgery, Third Affiliated Hospital, Zhongshan University, Guangzhou 510630, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2003 Oct;41(10):721-3.

Abstract

OBJECTIVE

To evaluate the feasibility and efficacy of a new method of endoscopic esophageal variceal ligation combined with partial splenic embolization (EVL-PSE) for the patients with portal hypertension.

METHODS

From May 1999 to February 2003, sixty-eight patients with portal hypertension underwent EVL-PSE, and hemodynamics of the portal trunk (PT), the left gastric vein and azygos vein, including maximum velocity, flow volume, vein diameter, were assessed using color ultrasound Doppler.

RESULTS

The esophageal varices and hypersplenism were greatly ameliorated after operation in patients who had undergone EVL-PSE. Postoperative portal trunk flow volume and velocity were significantly reduced (P < 0.05), and flow volume of the left gastric vein as well as the azygos vein were also reduced after operation. During 2 - 24-month follow-up, no recurrent bleeding was found.

CONCLUSIONS

EVL-PSE is less traumatic with less complications, and results in marked eradication of esophageal varices, it can be carried out safely in the clinical treatment for patients with portal hypertension.

摘要

目的

评估内镜下食管静脉曲张结扎术联合部分脾栓塞术(EVL-PSE)治疗门静脉高压症患者的可行性和疗效。

方法

1999年5月至2003年2月,68例门静脉高压症患者接受了EVL-PSE治疗,并采用彩色超声多普勒评估门静脉主干(PT)、胃左静脉和奇静脉的血流动力学,包括最大流速、血流量、静脉直径。

结果

接受EVL-PSE治疗的患者术后食管静脉曲张和脾功能亢进得到明显改善。术后门静脉主干血流量和流速显著降低(P < 0.05),胃左静脉和奇静脉的血流量术后也降低。在2至24个月的随访期间,未发现复发出血。

结论

EVL-PSE创伤小、并发症少,能显著消除食管静脉曲张,可在门静脉高压症患者的临床治疗中安全实施。

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