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目的 探讨超声引导下经皮穿肝胃底曲张静脉栓塞治疗肝硬化门脉高压急症上消化道出血的可行性及临床应用。方法 12例肝炎肝硬化病人均伴有不同程度的门静脉高压及消化道出血史 ,全部患者行胃镜检查均有胃底静脉曲张。超声引导下经皮穿肝至门脉造影 ,依据胃底曲张静脉的范围、数目及血流情况选择适当栓塞剂逐一栓塞胃冠状静脉、胃短静脉至再次造影时曲张静脉消失 ,栓塞前后记录门静脉压力变化。结果 12例患者栓塞后均停止出血 ,止血率 10 0 %。无 1例严重并发症出现 ,1例患者术后 3周死于心脏功能衰竭。 1个月生存率达 92 %。结论 超声导引下经皮穿肝胃底曲张静脉栓塞术治疗肝硬化门脉高压性急性消化道出血是安全有效的方法
Objective To investigate the feasibility and clinical application of ultrasound-guided percutaneous transhepatic variceal embolization in the treatment of upper gastrointestinal hemorrhage due to cirrhosis and portal hypertension. Methods Twelve patients with cirrhosis of liver were accompanied by different degrees of portal hypertension and gastrointestinal bleeding history. All patients underwent gastroscopy with gastric varices. Ultrasound-guided percutaneous transhepatic portal venography, according to the varicose veins of the varicose vein range, number and blood flow to select the appropriate embolic agent one by one embolization of gastric coronary vein, varicose veins to re-angiography varicose veins disappear, before and after embolization of the portal vein Pressure changes. Results All 12 patients stopped bleeding after embolization, and the rate of hemostasis was 100%. No one serious complications occurred, 1 patient died of heart failure 3 weeks after surgery. 1 month survival rate of 92%. Conclusion Ultrasound-guided percutaneous transhepatic variceal embolization for the treatment of portal hypertension in patients with acute gastrointestinal bleeding is a safe and effective method