经皮经脾胃冠状静脉栓塞术治疗日本血吸虫病慢性期上消化道出血。

Treatment of Upper Gastrointestinal Bleeding by Percutaneous Transsplenic Varices Embolization in Chronic Hepatic Schistosomiasis Japonicum Patients.

机构信息

Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

Department of Intervention Radiology, Jinshan Hospital, Fudan University, Shanghai, China.

出版信息

Am J Trop Med Hyg. 2021 Jul 19;105(4):1109-1113. doi: 10.4269/ajtmh.21-0304.

Abstract

To evaluate percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal bleeding (UGIB) in patients with chronic hepatic schistosomiasis japonicum (CHS), 29 CHS patients (20 males and 9 females) complicated with UGIB were selected as the investigation subjects. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition, the degrees of varices before and after PTSVE were evaluated by abdominal computed tomography (CT). Results showed that 26 CHS patients (89.6%) were successfully treated with PTSVE. Three cases (10.3%) failed, and two experienced intraperitoneal bleeding within 1 week after PTSVE. The abdominal CT showed a significant decrease of the varices stage in coronary (P < 0.001), esophageal (P = 0.006), and paraesophageal (P = 0.013) varices, but slightly increased perisplenic varices within 1 month of the intervention (P = 0.014). PTSVE may be a safe and effective procedure for the treatment of UGIB in CHS patients, particularly suitable for those with a widened hepatic fissure and exposed hepatic portal vein trunk and an enlarged spleen.

摘要

为了评估经皮经脾胃食管静脉曲张栓塞术(PTSVE)治疗日本血吸虫病慢性期(CHS)并发上消化道出血(UGIB)的效果,选择 29 例 CHS 合并 UGIB 患者作为研究对象,在 X 射线透视引导下行 PTSVE 治疗,观察 PTSVE 的成功率和并发症发生率,并通过腹部 CT 评估 PTSVE 前后静脉曲张程度。结果显示,26 例 CHS 患者(89.6%)成功接受 PTSVE 治疗,3 例(10.3%)失败,2 例在 PTSVE 后 1 周内出现腹腔内出血。腹部 CT 显示冠状静脉(P<0.001)、食管静脉(P=0.006)和食管旁静脉(P=0.013)的静脉曲张程度明显下降,但介入后 1 个月内脾周静脉曲张略有增加(P=0.014)。PTSVE 可能是治疗 CHS 患者 UGIB 的一种安全有效的方法,尤其适用于肝裂增宽、肝门静脉主干暴露和脾脏增大的患者。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索