Wang Hong-bo, Zhang An-zhong, Yang Chong-mei, Cui Yi, Zhang Jun-yong, Liu Fu-li, Zhang Chun-qing
Department of Gastroenterology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China. Email:
Zhonghua Yi Xue Za Zhi. 2012 Feb 14;92(6):411-3.
To evaluate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) plus embolotherapy in the treatment of patients with gastroesophageal varices.
A total of 36 patients with gastroesophageal varices underwent the therapies of TIPS plus embolotherapy from July 2005 to March 2011 at Provincial Hospital Affiliated to Shandong University. The rechecked items included abdominal ultrasound examination, liver function test and blood routine examination at Day 7 post-operation. All received endoscopic examinations at Month 1.
The technical success rate of TIPS plus embolotherapy was 100%. The portal vein pressures declined from (28 ± 8) mm Hg (1 mm Hg = 0.133 kPa) to (14 ± 7) mm Hg at post-operation. Angiography showed gastroesophageal varices disappeared in all patients. Both liver function and gastroesophageal varices markedly improved. During the follow-up period of 3 - 6 months, 4 cases had hepatic encephalopathy and 1 case stent restenosis at post-operation. And most cases were resolved after treatment. No rebleeding occurred during the follow-up period.
The combined modality of TIPS plus embolotherapy can effectively lower portal vein pressure and cure esophageal and gastric varice bleeding. As a safe and excellent interventional procedure with fewer complications and a lower recurrence rate of portal hypertension, it has great clinical values in the treatment of portal hypertension and gastroesophageal varices.
评估经颈静脉肝内门体分流术(TIPS)联合栓塞疗法治疗胃食管静脉曲张患者的疗效。
2005年7月至2011年3月,山东大学附属省立医院共有36例胃食管静脉曲张患者接受了TIPS联合栓塞疗法。复查项目包括术后第7天的腹部超声检查、肝功能检查和血常规检查。所有患者在术后1个月均接受了内镜检查。
TIPS联合栓塞疗法的技术成功率为100%。术后门静脉压力从(28±8)mmHg(1mmHg = 0.133kPa)降至(14±7)mmHg。血管造影显示所有患者的胃食管静脉曲张均消失。肝功能和胃食管静脉曲张均明显改善。在3至6个月的随访期内,4例患者术后发生肝性脑病,1例患者出现支架再狭窄。大多数病例经治疗后得到缓解。随访期间无再出血发生。
TIPS联合栓塞疗法可有效降低门静脉压力,治愈食管和胃静脉曲张出血。作为一种安全、优良的介入手术,并发症少,门静脉高压复发率低,在门静脉高压和胃食管静脉曲张的治疗中具有重要的临床价值。