[1]李建军,李 坤,朱培欣,等.双球囊阻断顺行经静脉闭塞术在胃静脉曲张破裂出血伴粗大型自发性门体静脉分流患者的应用[J].介入放射学杂志,2026,(05):545-551.[doi:10.3969/j.issn.1008-794X.2026.05.014 ]
　LI Jianjun,LI Kun,ZHU Peixin,et al.Application of double balloon-occluded antegrade transvenous obliteration in gastric variceal rupture with bleeding accompanied by large spontaneous portosystemic shunts[J].J Intervent Med,2026,(05):545-551.[doi:10.3969/j.issn.1008-794X.2026.05.014 ]
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双球囊阻断顺行经静脉闭塞术在胃静脉曲张破裂出血伴粗大型自发性门体静脉分流患者的应用()

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

卷:
期数:
2026年05
页码:
545-551
栏目:
临床研究
出版日期:
2026-05-25

文章信息/Info

Title:
Application of double balloon-occluded antegrade transvenous obliteration in gastric variceal rupture with bleeding accompanied by large spontaneous portosystemic shunts
文章编号:
1008-794X(2026)-005-0545-06
作者:
李建军;  李 坤;  朱培欣;  陈锦州
467000 河南平顶山 河南平煤神马集团总医院介入血管外科(李建军、朱培欣、陈锦州); 河南省人民医院血管外科(李 坤);
Author(s):
LI Jianjun; LI Kun; ZHU Peixin; CHEN Jinzhiou.
Department of Interventional and Vascular Surgery,Pingmeishenma Group General Hospital,Pingdingshan,Henan Province 467000,China
关键词:
球囊阻断技术;  胃静脉曲张;  自发性门体静脉分流;  门静脉压力梯度
分类号:
R657.34
DOI:
10.3969/j.issn.1008-794X.2026.05.014
文献标志码:
B
摘要:
目的 评价双球囊阻断顺行经静脉闭塞术(double balloon-occluded antegrade transvenous obliteration,DBATO)治疗胃静脉曲张破裂出血伴粗大型自发性门体静脉分流(spontaneous portosystemic shunt,SPSS)的临床效果及对门静脉压力梯度(portal pressure gradient,PPG)的影响。方法 回顾性分析2022年12月至2024年6月河南省人民医院采用DBATO术治疗的24例肝硬化门静脉高压所致胃静脉曲张破裂出血伴粗大型SPSS患者临床资料。观察术中PPG变化,术后手术止血效果、手术相关并发症,随访再出血率、长期止血效果。结果 手术技术成功率为100%。15例(62.5%)患者伴食管静脉曲张,同台接受胃冠状静脉栓塞术; 13例(54.2%)伴有脾功能亢进,同台接受部分脾动脉栓塞术。门静脉穿刺相关出血1例,临床止血率为100%。无肺动脉、门静脉严重异位栓塞,微栓塞分别有6例(25.0%)、2例(8.3%)。PPG水平在胃曲张静脉和SPSS栓塞后明显高于栓塞前(P<0.001),接受脾动脉栓塞术后显著下降(t=4.85,P<0.001),但比术前仍有升高(P<0.05)。中位随访8个月(3～17个月),7例(29.2%)患者接受二期经颈静脉肝内门体分流术,其中3例(12.5%)因再发消化道出血。结论 DBATO术治疗门静脉高压所致胃静脉曲张破裂出血伴粗大型SPSS具有显著的临床止血效果,无严重异位栓塞发生。

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(收稿日期:2025-03-19)
(本文编辑:谷 珂)

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备注/Memo

备注/Memo:
通信作者: 李 坤 E-mail:likun1331@163.com
更新日期/Last Update: 2026-05-25