Tajiri T, Umehara M, Tei J, Kim D Y, Aoki N, Yamashita K, Onda M
Nihon Geka Gakkai Zasshi. 1985 Sep;86(9):1227-30.
Transcatheter variceal embolization (PTO, TIO) has been performed in 71 cases and splenic artery embolization (SAE) in 22 cases (15 PTO-SAE combination and 7 SAE alone). Results for varices of PTO combined with SAE were better than with PTO alone. Furthermore PTO combined with SAE was found to be reliable even for long term control of bleeding, the longest follow up being almost over 3 years during which time we have had no case of rebleeding. Improvement of Child's criteria was seen to be better in SAE cases (52.4%) than in splenectomized cases (12.5%) and PTO alone (17.4%). Hepaplastin test and level of cholinesterase were used to assess liver function, before and after treatment. It was found that SAE cases improved considerably, in contrast to the splenectomized and control cases which showed little or no improvement. Thus to increase durability for long term control of bleeding and general condition, PTO should be combined with SAE. Furthermore, it is suggested that this combined embolization therapy should be used for nonsurgical treatment of esophageal varices and hypersplenism with liver cirrhosis.
已对71例患者实施经导管静脉曲张栓塞术（PTO、TIO），对22例患者实施脾动脉栓塞术（SAE）（15例为PTO-SAE联合治疗，7例为单纯SAE）。PTO联合SAE治疗静脉曲张的效果优于单纯PTO。此外，发现PTO联合SAE即使对于长期控制出血也很可靠，最长随访时间近3年，在此期间我们没有再出血病例。SAE病例中Child标准的改善情况（52.4%）优于脾切除病例（12.5%）和单纯PTO病例（17.4%）。在治疗前后，使用肝促凝血酶原激酶试验和胆碱酯酶水平评估肝功能。发现SAE病例有显著改善，而脾切除病例和对照病例改善很少或没有改善。因此，为提高长期控制出血的持久性和整体状况，PTO应与SAE联合使用。此外，建议这种联合栓塞疗法应用于肝硬化食管静脉曲张和脾功能亢进的非手术治疗。
