Karimov Sh I, Magamadov U A, Akhtaev A R, Kim V F, Iunusov I R
Khirurgiia (Mosk). 1989 Feb(2):32-5.
The article deals with the results of treatment of 27 patients with profuse esophageal hemorrhage in portal hypertension. Sixteen patients were treated by roentgen-guided endovascular surgery, namely, transhepatic transportal embolization of varicose veins of the esophagus and stomach. In view of the peculiarities of blood drainage and for the prevention of recurrent bleeding, seven patients were subjected to additional manipulations: embolization of the splenic artery (4) and the left gastric artery (3). Despite reliable arrest of bleeding, 3 patients died in the first 2-3 days from progressive hepatorenal failure. Only one patient had recurrent bleeding in the late-term period. The authors believe transhepatic transportal embolization of the gastroesophageal veins at the peak of hemorrhage to be a hardly injurious and effective method for its arrest.
本文探讨了27例门静脉高压症所致食管大出血患者的治疗结果。16例患者接受了X线引导下的血管内手术，即经肝门静脉栓塞食管和胃的曲张静脉。鉴于血液引流的特点及预防再出血，7例患者接受了额外的操作：脾动脉栓塞（4例）和胃左动脉栓塞（3例）。尽管出血得到了可靠控制，但3例患者在最初2 - 3天因进行性肝肾衰竭死亡。仅1例患者在后期出现复发出血。作者认为在出血高峰期对胃食管静脉进行经肝门静脉栓塞是一种损伤小且有效的止血方法。
