[1]姜在波,李征然,钱结胜,等.以NBCA栓塞治疗门脉高压性上消化道出血[J].介入放射学杂志,2007,(10):661.
 JIANG Zai-bo,LI Zheng-ran,QIAN Jie-sheng,et al.Obliteration of gastric bleeding varices with NBCA[J].journal interventional radiology,2007,(10):661.
点击复制

以NBCA栓塞治疗门脉高压性上消化道出血()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2007年10期
页码:
661
栏目:
血管介入
出版日期:
2007-10-15

文章信息/Info

Title:
Obliteration of gastric bleeding varices with NBCA
作者:
姜在波李征然钱结胜
510630广州中山大学附属第三医院介入治疗专科
Author(s):
JIANG Zai-boLI Zheng-ranQIAN Jie-shengZHU Kang-shunHUANG Ming-shengZHAO Da-bingPANG Peng-feiGUAN Shou-haiSHAN Hong.
Department of Interventional Therapy,Third Affiliated Hospital,SUN YET-SEN University,Guangzhou510630,China
关键词:
门脉高压静脉曲张栓塞NBCA
分类号:
R575.21
文献标志码:
A
摘要:
目的研究以NBCA(N-Butyl-2-Cyanoacrylate)栓塞治疗晚期肝病所致门脉高压性上消化道出血的可行性。方法17例门脉高压性上消化道出血患者,皆显示胃冠状静脉、胃底静脉曲张,并显示脾-肾分流3例,胃-肾分流3例。9例择期手术,8例急诊手术。由右腋中线经右肝入路7例,由剑突下经左肝入路4例,经脾静脉入路6例,NBCA与超液化碘油比例为1∶4,栓塞程度以曲张静脉消失为目的。随访观察患者的生存期、症状改善情况等。结果17例患者手术全部成功,栓塞后造影显示曲张静脉完全闭塞,栓塞后门脉压力较术前平均升高3cm H 2 O,术中仅1例患者出现刺激性咳嗽,未发生与手术相关的严重并发症。术后1个月内患者症状均明显改善,未发生消化道出血、顽固性腹水等症状,复查CT增强扫描显示曲张静脉消失。随访3~12个月,患者生存期平均超过5个月,随访期内4例患者死亡,死亡原因主要为肝功能衰竭,其中3例患者合并少量消化道出血。结论以NBCA栓塞治疗晚期肝病导致门脉高压性消化道出血技术可行,疗效可靠,并发症少,严格地选择适应证能明显提高远期疗效。

参考文献/References:

[1]Kiyosue H,Matsumoto H,Yamada Y,et al.Transportal intra-variceal sclerotherapy with N-butyl-2-cyanoacrylate for gastric varices[J].J Vasc Intervent Radiol,2004,15:505-509.
[2]刘效恭,高寰,王英,等.直视下胃冠状静脉栓塞术十年经验总结[J].肝胆胰外科杂志,1996,8:28-31.
[3]胡元明,谢宗贵,单鸿,等.经皮经肝食管胃底静脉曲张栓塞术的临床应用[J].中华放射学杂志,2005,39:736-739.
[4]于淼,张金山.经自发性脾-肾或胃-肾分流道栓塞曲张的胃底静脉临床研究[J].中国医学影像技术杂志,2002,18:796-797.
[5]刘清欣,颜志平,王建华,等.冠状静脉栓塞术在门静脉高压症治疗中的应用[J].中国实用外科杂志,2001,21:590-591.
[6]崔进国,梁志会,周桂芬,等.经颈静脉肝内门-体静脉分流术同时行胃冠状静脉及胃短静脉栓塞术治疗肝硬化门脉高压并消化道出血[J].临床放射学杂志,2003,22:501-503.
[7]张曦彤,徐克,王长龙,等.肝硬变门脉高压及食管胃底静脉曲张的介入性分流加断流术治疗[J].中国医科大学学报,1995,24:274-277.
[8]李彦豪,何晓峰,陈勇,等.TIPSS中弹性通道扩张术及胃冠状静脉栓塞术的应用[J].中国医学影像学杂志,1997,5:234-235.
[9]张太平,郑莲芳,刘效恭,等.胃冠状静脉栓塞术后早期胃粘膜超微结构变化[J].新乡医学院学报,1994,11:135-137.
[10]张同琳,陈浩辉,侯宽永,等.胃冠状静脉栓塞术后胃壁坏死[J].北京医科大学学报,1996,28:452-453.
[11]Kiyosue H,Mori H,Matsumoto S,et al.Transcatheter oblitera-tion of gastric varices part1.anatomic classification[J].Radiographics,2003,23:911-920.
[12]Kiyosue H,Mori H,Matsumoto S,et al.Transcatheter obli-teration of gastric varices part2.strategy and techniques based on hemodynamic features[J].Radiographics,2003,23:921-937.
[13]陈宇,石木兰.门静脉高压静脉曲张的CT表现[J].临床放射学杂志,2000,19:63-65.
[14]Kang HK,Jeong YY,Choi JH,et al.Three-dimensional Multi-detector row CT portal venography in the evaluation of portosystemic collateral vessels in liver cirrhosis[J].Radiographics,2002,22:1053-1061.
[15]Willmann J K,Weishaupt D,Bihm T,et al.Detection of sub-mucosal gastric fundal varices with multi-detector row CT angiography[J].Gut,2003;52:886-892.
[16]祖洁,李国均,尹忠诚.经皮经脾穿刺行食管胃底静脉栓塞治疗消化道大出血[J].徐州医学院学报,2005,25:254-255.

相似文献/References:

[1]周东海,任伟新,赵志文,等.介入治疗急性大出血25例临床总结[J].介入放射学杂志,2010,(09):729.
 ZHOU Donghai,REN Weixin,ZHAO Zhiwen,et al.Clinical application of interventional therapy in treating acute massive hemorrhage[J].journal interventional radiology,2010,(10):729.
[2]吴瑕,徐克.改良式TIPS的解剖学基础研究[J].介入放射学杂志,2007,(05):316.
 WU Xia,XU Ke.Basic anatomic study of transjugular intrahepatic portosystemic shunt by direct transcaval approach[J].journal interventional radiology,2007,(10):316.
[3]王青,兰春虎,赵玲.经皮经肝门静脉栓塞食管胃底静脉治疗门脉高压性上消化道出血[J].介入放射学杂志,2006,(01):44.
 WANG Qing,LAN Chun-hu,ZHAO Ling.Treatment of portal hypertensive upper gastrointestinal hemorrhage by percutaneous transhepatic esophagogastric varices embolization[J].journal interventional radiology,2006,(10):44.
[4]陆立,周良,栾小丹,等.激光腔内治疗下肢静脉曲张29例[J].介入放射学杂志,2009,(10):730.
 LU Li,ZHOU Liang,LUAN Xiaodan,et al.Endovenous laser ablation for the treatment of varicose veins in the lower extremities:a clinical analysis of 29cases[J].journal interventional radiology,2009,(10):730.
[5]倪明,吕维富,邓克学.肝硬化患者CT门静脉血管成像中门静脉侧支血管的表现[J].介入放射学杂志,2009,(11):823.
 NI Ming,LWeifu,DENG Kexue.CT portal venography manifestations of portal collateral circulation in patients with portal hypertension due to cirrhosis[J].journal interventional radiology,2009,(10):823.
[6]李赵鹏,赵卫.脾脏射频消融治疗门脉高压性脾功能亢进的研究进展[J].介入放射学杂志,2009,(12):953.
 LI Zhaopeng,ZHAO Wei.Splenic radiofrequency ablation for the treatment of hypersplenism due to portal hypertension:recent progress in clinical research[J].journal interventional radiology,2009,(10):953.
[7]傅建华,何 旭,王亚非,等.下肢静脉曲张硬化治疗的现状与进展[J].介入放射学杂志,2011,(09):753.
 FU Jian-hua,HE Xu,WANG Ya-fei,et al.The sclerotherapy of varicose veins of the lower limbs: its current situation and recent progress[J].journal interventional radiology,2011,(10):753.
[8]何旭,顾建平,楼文胜,等.介入法腔内射频闭合术治疗大隐静脉曲张[J].介入放射学杂志,2008,(01):33.
 HE Xu,GU Jianping,LOU Wensheng,et al.Endovenous radiofrequency obliteration of great saphenous varicosity[J].journal interventional radiology,2008,(10):33.
[9]汪涛,何旭,顾建平.下肢静脉曲张的微创治疗[J].介入放射学杂志,2008,(01):66.
 WANG Tao,HE Xu,GU Jianping.Minimally invasive treatment for varicose vein in lower limbs[J].journal interventional radiology,2008,(10):66.
[10]郑世宾,郭衍,孙成宏,等.支架成形术治疗以静脉性溃疡为主要表现的非血栓性髂静脉病变效果[J].介入放射学杂志,2020,29(01):25.
 ZHENG Shibing,GUO Heng,SUN Chenghong,et al.The curative effect of stent angioplasty for the treatment of non-thrombotic iliac vein lesions characterized mainly by venous ulcers[J].journal interventional radiology,2020,29(10):25.

备注/Memo

备注/Memo:
收稿日期:2007-03-13
更新日期/Last Update: 2007-10-15