[1]邹凯丽,王冠武,李文军,等.急诊胃静脉栓塞术治疗急性食管胃底静脉曲张破裂出血的近期及长期疗效分析[J].介入放射学杂志,2025,34(08):860-864.[doi:10.3969/j.issn.1008-794X.2025.08.011 ]
　ZOU Kaili,WANG Guanwu,LI Wenjun,et al.Emergency gastric vein embolization for the treatment of acute esophageal and gastric variceal bleeding:analysis of its short-term and long-term efficacy[J].J Intervent Med,2025,34(08):860-864.[doi:10.3969/j.issn.1008-794X.2025.08.011 ]
点击复制

急诊胃静脉栓塞术治疗急性食管胃底静脉曲张破裂出血的近期及长期疗效分析 ()

PDF下载中关闭

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

卷:
34
期数:
2025年08
页码:
860-864
栏目:
临床研究
出版日期:
2025-08-25

文章信息/Info

Title:
Emergency gastric vein embolization for the treatment of acute esophageal and gastric variceal bleeding:analysis of its short-term and long-term efficacy
文章编号:
1008-794X(2025)-008-0860-06
作者:
邹凯丽;  王冠武;  李文军;  孔铭新;  唐世伟
261000 山东潍坊 潍坊市人民医院(山东第二医科大学第一附属医院)药剂科(邹凯丽),介入放射科(王冠武、李文军、孔铭新、唐世伟)
Author(s):
ZOU Kaili; WANG Guanwu; LI Wenjun; KONG Mingxin; TANG Shiwei.
Department of Pharmacy and Department of Interventional Radiology,Weifang Municipal People's Hospital(First Affiliated Hospital of Shandong Second Medical University),Weifang,Shandong Province 261000,China
关键词:
急诊;  胃静脉栓塞术;  食管胃底静脉曲张破裂出血;  门静脉高压症
分类号:
R657.3+1
DOI:
10.3969/j.issn.1008-794X.2025.08.011
文献标志码:
B
摘要:
目的 评估急诊胃静脉栓塞术(GVE)治疗急性食管胃底静脉曲张出血(EGVB)的安全性和临床疗效。方法 回顾性分析潍坊市人民医院2018 年 1 月至 2021 年 12 月期间72例接受急诊GVE治疗的急性EGVB患者临床资料。所有患者术前及术后均未接受过 TIPS 、内镜结扎、硬化剂注射或手术等其他治疗。观察指标包括手术成功率、严重并发症、止血成功率、住院时间和费用、再出血发生率及死于再出血的发生率,该研究的终点是发生再出血或死亡。结果 手术成功率为98.6%,止血成功率为91.7%,无严重并发症。除10例患者在住院期间死亡外,62例健康状况明显改善并经治疗后出院,患者平均住院时间为9 d,平均住院费用3.8万元人民币; 该62例患者中,入院后直接急诊行GVE的患者设为A组,保守治疗失败后急诊进行GVE的患者设为B组,A组患者的住院时间短于B组,但住院费用相似。该62例患者中,1年内再出血发生率为37.1%,2年内发生率为53.2%。1年和2年内死于再出血的发生率均为14.5%。结论 急诊GVE治疗急性EGBV止血安全有效,尽早完成能够降低患者的死亡风险及成本,应成为急性EGBV的常规治疗方法之一。GVE术后再出血发生率较高,联合内镜下治疗可能能降低再出血发生率,但需要进一步研究来验证。

参考文献/References:

[1] Elghezewi A,Hammad M,El-Dallal M,et al.Trends in hospitalizations of esophageal varices from 2011 to 2018:A United States Nationwide study[J].Gastroenterology Res,2023,16:171-183.
[2]Reiberger T,Lens S,Cabibbo G,et al.EASL position paper on clinical follow-up after HCV cure[J].J Hepatol,2024,81:326-344.
[3]Wang C,Han J,Xiao L,et al.Efficacy of vasopressin/terlipressin and somatostatin/octreotide for the prevention of early variceal rebleeding after the initial control of bleeding:a systematic review and meta-analysis[J].Hepatol Int,2015,9:120-129.
[4]Martinez J,Hernandez-Gea V,Rodríguez-de-Santiago E,et al.Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis[J].J Hepatol,2021,75:342-350.
[5]Hidaka H,Nakazawa T,Wang G,et al.Long-term administration of PPI reduces treatment failures after esophageal variceal band ligation:a randomized,controlled trial[J].J Gastroenterol,2012,47:118-126.
[6]中华医学会肝病学分会,中华医学会消化病学分会,中华医学会消化内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].临床肝胆病杂志,2023,39:527-538.
[7]Holster IL,Tjwa ET,Moelker A,et al.Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy +β-blocker for prevention of variceal rebleeding[J].Hepatology,2016,63:581-589.
[8]Paleti S,Nutalapati V,Fathallah J,et al.Balloon-occluded retrograde transvenous obliteration(BRTO)versus transjugular intrahepatic portosystemic shunt(TIPS)for treatment of gastric varices because of portal hypertension:a systematic review and meta-analysis[J].J Clin Gastroenterol,2020,54:655-660.
[9]Sarin SK,Lahoti D,Saxena SP,et al.Prevalence,classification and natural history of gastric varices:a long-term follow-up study in 568 portal hypertension patients[J].Hepatology,1992,16:1343-1349.
[10]Paternostro R,Kwanten WJ,Hofer BS,et al.Hepatic venous pressure gradient predicts risk of hepatic decompensation and liver-related mortality in patients with MASLD[J].J Hepatol,2024,81:827-836.
[11]Park GW,Choi SY,Kim YJ,et al.Usefulness of antegrade foam sclerotherapy for portal hypertensive variceal bleeding[J].Diagn Interv Radiol,2023,29:826-831.
[12]朱 军,徐晓茜,罗剑钧,等.经皮脾静脉成形术治疗胰源性门静脉高压症[J].介入放射学杂志,2018,27:415-418.
[13]Gralnek IM,Camus Duboc M,Garcia-Pagan JC,et al.Endoscopic diagnosis and management of esophagogastric variceal hemorrhage:European Society of Gastrointestinal Endoscopy(ESGE)Guideline[J].Endoscopy,2022,54:1094-1120.
[14]Huang Y,Wang X,Li X,et al.Comparative efficacy of early TIPS,Non-early TIPS,and Standard treatment in patients with cirrhosis and acute variceal bleeding:a network meta-analysis[J].Int J Surg,2024,110:1149-1158.
[15]唐世伟,赵新建,王忠敏,等.TIPS对比EBL治疗肝硬化食管静脉曲张出血Meta分析[J].介入放射学杂志,2016,25:761-765.
[16]Lv Y,Qi X,He C,et al.Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis:a randomised controlled trial[J].Gut,2018,67:2156-2168.
[17]Bhardwaj A,Kedarisetty CK,Vashishtha C,et al.Carvedilol delays the progression of small oesophageal varices in patients with cirrhosis:a randomised placebo-controlled trial[J].Gut,2017,66:1838-1843.
(收稿日期:2024-12-23)
(本文编辑:茹 实)

相似文献/References:

[1]周兵,袁建华.提高介入放射学在急症医学中的地位[J].介入放射学杂志,2009,(06):401.
　ZHOU Bing,YUAN Jian-hua.Promoting interventional radiology in clinical practice of emergency medicine[J].J Intervent Med,2009,(08):401.
[2]夏风飞,张成德,杨芳,等.急诊介入治疗原发性抗磷脂综合征并急性大面积肺栓塞1例 [J].介入放射学杂志,2020,29(03):259.
　XIA Fengfei,ZHANG Chengde,YANG Fang,et al.Emergency interventional treatment of primary antiphospholipid syndrome associated with acute massive pulmonary embolism: report of one case[J].J Intervent Med,2020,29(08):259.
[3]中国研究型医院学会出血专业委员会,中国出血中心联盟.致命性大出血急救护理专家共识（2019） [J].介入放射学杂志,2020,29(03):221.
　Haemorrhage Professional Committee of Chinese Research Hospital Association,China Haemorrhage Center Alliance.Expert consensus on emergency nursing for fatal haemorrhage（2019）[J].J Intervent Med,2020,29(08):221.

备注/Memo

备注/Memo:
基金项目: 潍坊市卫健委科研项目(WFWSJK-2025-157)
通信作者: 唐世伟 E-mial:13356727373@163.com
更新日期/Last Update: 2025-08-25