Watanabe Manabu, Shiozawa Kazue, Ikehara Takashi, Nakano Shigeru, Kougame Michio, Otsuka Takafumi, Kikuchi Yoshinori, Ishii Koji, Igarashi Yoshinori, Sumino Yasukiyo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-8541, Japan.
ISRN Gastroenterol. 2012;2012:919371. doi: 10.5402/2012/919371. Epub 2012 Dec 5.
The short-term effects of balloon-occluded retrograde transvenous obliteration (BRTO) to treat gastric varices were evaluated by using computed tomography (CT) and gastroscopy (GF). The subjects were 77 patients who underwent BRTO to treat gastric varices. The short-term effects of BRTO were investigated with regard to ascites, pleural effusion, venous thrombus, and esophageal varices by comparing the findings of CT and GF performed within one month before and after BRTO. The mean duration of followup was 960.1 days. Ascites and pleural effusion were exacerbated after BRTO in 26 (33.8%) and 31 (40.3%), respectively. A significant difference in ascites exacerbation was noted in patients with hypoalbuminemia and a high Child-Pugh score, and a significant difference in exacerbation of pleural effusion was noted in patients with hypoalbuminemia. Venous thrombus was noted in 7 patients (9.1%). Esophageal varices were exacerbated in 14 (21.2%) of the 66 patients. The 2-year survival rate was 720 days, and significant differences were noted in the Child-Pugh classification and the concomitance of hepatocellular carcinoma (HCC) on multivariate analysis of prognosis-related factors. Conclusion. The frequencies of exacerbation of ascites, pleural effusion, and esophageal varices after BRTO were high but these may not be related to survival.
采用计算机断层扫描(CT)和胃镜检查(GF)评估球囊闭塞逆行静脉栓塞术(BRTO)治疗胃静脉曲张的短期效果。研究对象为77例行BRTO治疗胃静脉曲张的患者。通过比较BRTO前后1个月内CT和GF的检查结果,研究BRTO对腹水、胸腔积液、静脉血栓和食管静脉曲张的短期影响。平均随访时间为960.1天。BRTO后腹水和胸腔积液分别在26例(33.8%)和31例(40.3%)中加重。低白蛋白血症和Child-Pugh评分高的患者腹水加重有显著差异,低白蛋白血症患者胸腔积液加重有显著差异。7例(9.1%)出现静脉血栓。66例患者中有14例(21.2%)食管静脉曲张加重。2年生存率为720天,在对预后相关因素进行多变量分析时,Child-Pugh分级和肝细胞癌(HCC)的合并情况有显著差异。结论。BRTO后腹水、胸腔积液和食管静脉曲张加重的发生率较高,但这些可能与生存率无关。