【摘要】 目的:比较经皮肝TH胶‘三明治’灌注栓塞与内镜下套扎治疗食管胃底静脉曲张的近、远期疗效及并发症。方法:将51例门脉高压食管静脉曲张破裂出血患者,随机分为2组。TH胶栓塞组:TH胶“三明治”灌注栓塞(无水乙醇-TH胶-纤毛钢圈)胃冠状静脉+部分脾栓塞(PTEV+PSE)27例;套扎组:食管胃底静脉曲张内镜密集套扎(DEVL)24例。分别观察两组术后再出血率、病死率、并发症。结果:两组6、12、24月再出血率分别为3%与7%、6.4%与13.4%、9.7%与19.7%(P<0.01);两组病死率分别为4.3%、18.2%(P<0.01);两组腹痛、发热超过半月者分别为59%与21%、62.9%与21%,感染发生率分别为18.5%与8.3%(P均<0.01)。结论:TH胶栓塞组并发症发生率高于内镜下套扎组,但多能耐受;其再出血率、病死率均明显优于内镜下套扎组,是治疗食管静脉曲张的合理方法。更多还原

【Abstract】 Objective:To compare the short and long-term therapeutic effect and complications of TH glue profusing embolization through percutaneous liver puncture and endoscopic knot ligation in treatment of esophageal varicosity.Methods:Fifty-one cases with portal hypertension and rupture of esophageal varices were divided into two gruops.TH glue perfusing embolization group(27 cases with PTEV+PSE partial splenic embolization)and endoscopic knot ligation groups(24 cases).The rate of bleeding,mortality and complications were observed.Results:The rate of bleeding were 3% vs 7%,6.4% vs 13.4%,9.7% vs 19.7% at the 6,12 and 24 months in the two groups respectively(P<0.01).The mortality rate were 4.3% vs 18.2%(P<0.01).Symptoms of abdominal pain and fever lasted more than half a month were 59% vs 21%,62% vs 21% respectively.The rate of developing infection was 18.5% vs 8.3%(P<0.01).Conclusion:The rate of developing complications is higher in TH glue embolization group than that in the endoscopic knot ligation group,but most of patients can tolerate it.The bleeding rate and mortality rate are significantly superior to those in the endoscopic knot ligation group.It is a rational treatment for esophageal varicosity.更多还原