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目的 探讨急诊内镜套扎联合部分脾动脉栓塞术治疗门静脉高压并发上消化道急性出血的疗效。方法 对 4 8例门静脉高压并食管胃底静脉曲张破裂急性出血患者行急诊内镜下曲张静脉套扎术(EVL) ,联合部分脾动脉栓塞术 (PSE) ,观察近期止血效果和远期再出血发生率及外周血细胞等变化。结果 EVL PSE联合术近期止血效果显著 (10 0 % ) ,食管胃底曲张静脉消失率达 6 8.75 % (33/48) ;无手术死亡 ,无严重并发症 ,远期再出血率 6 .2 5 % (3/48) ,外周血白细胞及血小板均较术前明显回升 (P <0 .0 5 )。结论 联合术能有效地救治门静脉高压并食管胃底静脉曲张破裂急性出血 ,减少单纯内镜下套扎治疗的次数和复发再出血的风险。该法创伤小 ,安全有效。
Objective To investigate the efficacy of emergency endoscopic ligation combined with partial splenic arterial embolization in the treatment of portal hypertension associated with acute upper gastrointestinal bleeding. Methods Forty-eight patients with acute portal hypertension and esophagogastric variceal bleeding underwent emergency endoscopic varicose vein ligation (EVL) combined with partial splenic arterial embolization (PSE). The effect of immediate hemostasis and long-term rebleeding Incidence and changes in peripheral blood cells. Results The effect of hemostasis in EVL PSE combined surgery was significant (10 0%). The disappearance rate of esophageal and gastric varices reached 6 8.75% (33/48). There was no operative death, no serious complication and long-term rebleeding rate was 6.52 % (3/48), peripheral white blood cells and platelets were significantly higher than before surgery (P <0. 05). Conclusion Combined surgery can effectively treat portal hypertension and esophageal variceal bleeding, reducing the number of endoscopic ligation and the risk of recurrent hemorrhage. The law trauma, safe and effective.