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目的探讨双介入治疗对肝硬化门静脉高压性上消化道出血、脾功能亢进的临床价值及并发症的预防。方法对11例确诊为肝硬化门静脉高压合并上消化道出血、脾功能亢进的患者,在B超引导下经皮肝门脉穿刺成功后,将导管超选择插入胃冠状静脉,再经股动脉穿刺插管、超选插入脾动脉分支,混合应用无水酒精、明胶海绵、不锈钢弹簧圈,进行双介入栓塞(胃底食管曲张静脉及部分脾脏栓塞)治疗。结果11例患者术后均有不同程度的发热、腹痛、恶心及呕吐等栓塞后综合征,经对症治疗后缓解、症状消失。24 h~1周白细胞、血小板明显升高。12月内上消化道出血控制率达100%。结论双介入治疗门脉高压性上消化道出血、脾功能亢进,疗效确切。
Objective To investigate the clinical value and prevention of double interventional therapy on portal hypertension in patients with cirrhosis of upper gastrointestinal bleeding and hypersplenism. Methods Eleven patients with cirrhosis complicated with upper gastrointestinal hemorrhage and hypersplenism were diagnosed as cirrhosis complicated with upper gastrointestinal bleeding and hypersplenism. After percutaneous transhepatic portal venous puncture under the guidance of B-ultrasound, the catheter was surgically inserted into the gastric coronary vein. Intubation, superselective insertion of the splenic artery branch, mixed application of anhydrous alcohol, gelatin sponge, stainless steel coil, for double interventional embolization (gastric esophageal varicose vein and partial splenic embolization) treatment. Results All 11 patients had post-embolization syndromes such as fever, abdominal pain, nausea and vomiting. After symptomatic treatment, they were relieved and the symptoms disappeared. 24 h ~ 1 week leukocytes, platelets increased significantly. December upper gastrointestinal bleeding control rate of 100%. Conclusion Double interventional treatment of portal hypertension in upper gastrointestinal bleeding, hypersplenism, the exact effect.