控制胃静脉曲张出血及消除静脉瘤体的介入治疗

朱燕华; 吴巍; 吴云林

控制胃静脉曲张出血及消除静脉瘤体的介入治疗

上海交通大学医学院附属瑞金医院消化内科

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中图分类号: R575.2
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出版历程
- 出版日期: 2010-06-20

The interventional therapy for bleeding control and varices obliteration in gastric varices

摘要

摘要: 食管胃静脉曲张是与门脉最相关的侧支循环途径,其破裂可导致静脉曲张出血,是肝硬化最常见的致死性并发症。胃静脉曲张在门脉高压患者中的发生率为5%～33%,总出血概率为3%～30%,其破裂出血引起的病死率高达30%～53%。胃静脉曲张出血控制难度较大,治疗手段又落后于食管静脉曲张。但是从上世纪以来,对于胃静脉曲张的治疗,尤其是介入治疗方面有了巨大的进步,如内镜下血管闭塞治疗、经颈静脉肝内门腔静脉内支架分流术（TIPS）、球囊闭塞下经静脉逆行栓塞术（B-RTO）及经皮经肝食管胃底曲张静脉栓塞术（PTVE）等。这些方法在临床上的合理应用提高了危重患者的生存率,帮助无法耐受手术治疗的门脉高压患者改善生活质量。同时,也为患者等待肝移植创造了时间和条件。
- 食管和胃静脉曲张 /
- 胃肠出血 /
- 内窥镜检查
Abstract: Gastroesophageal varices are the most relevant portosystemic collaterals, and their rupture results in variceal hemorrhage which is the most common lethal complication of cirrhosis.The prevalence of gastric varices is 5% ～ 33% in patients who have portal hypertension, with an overall incidence of bleeding ranging from 3% ～ 30%.Mortality associated with gastric variceal hemorrhage reaches up to 30% ～ 53%.However, the management of gastric variceal hemorrhage is lagging behind.Fortunately, there has been great improvements in the therapy for gastric varices over the last decade, especially in the interventional therapy, such as endoscopic obturation, transjugular intrahepatic portosystemic stent shunt (TIPS) , Balloon-occluded retrograde transvenous obliteration (B-RTO) and percutaneous transhepatic variceal embolization (PTVE) .The proper use of these methods have increased the survival rate in severe patients and improved the quality of life in those who can not endure the surgery.Simultaneously, interventional therapy also makes it possible for the patients waiting for liver transplantation to gain more time and chances.
- esophageal and gastric varices /
- gastrointestinal hemorrhage /
- endoscopy

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参考文献(23)

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