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Evaluation of Double Interventional Treatment of Acute Variceal Hemorrhage in Por－tal Hypertension

杨海山  王大伟  来颖  刘丙义  李晨玉

Yang Hai－Shan，Wang Da－wei，Lai Ying，et a1．The Third Clinical College Of Norman Bethune

University Of Medical Sciences，Changchun 130021

Abstract

　　From November 1991 to October 1992，We performed a clinical trial of percutaneous transhepatic coronary and short gastricvein，andpartial splenic artery embolization for recurrent esephageal variceal bleeding and hypersplenism．The patients treated and followed for 8 to 11 months showed good response on perpheral blood count，There was no recurrence of esophageal bleeding．Absolute ethanol is an effective sclerosing agent in the treatment of bleeding gastric and esophageal varices．Embolization with gelfoam stripes was used for the main trunks of coronry，short gastric veins and Splenic artery．The procedure and Clinical value of this technique were discussed portal．

　　Key words：Hypertension；Hypersplenism；Hemorrhage；Embolization；therapeutic

　　门脉高压有四种常见并发症^[1]，其中食管胃曲张静脉出血是致死的主要原因。目前治疗仍很困难，手术死亡率较高。经皮穿肝食管胃曲张静脉栓塞术（PTVO）^[2]是用于控制门脉高压大出血的一项新的非手术疗法。国内临床应用较少^[2，3]，国外应用较多^[4－8]。我们采用PTVO和部分脾动脉栓塞（PSAE）技术同时对门脉高压急性出血和脾亢病人进行治疗，其疗效满意。笔者复习文献^[1－9]尚未发现PTVO和PSAE同时应用的报道。两法联合应用除止血效果优于单纯PTVO或PSAE外，还可获得栓塞前后门脉血液动力学的变化。