超声引导对经皮肝胃冠状静脉栓塞术的辅助作用.pdf

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1、·652·局解手术学杂志2013年第22卷第6期JREGANATOPERSURG，2013，Vo1．22，No．6超声引导对经皮肝胃冠状静脉栓塞术的辅助作用李劲松，张俊文，刘强(1．重庆市大足双桥经开区人民医院内二科，重庆大足400900；2．重庆医科大学附属第一医院消化内科，重庆400016)『摘要]目的探讨超声引导对经皮肝胃冠状静脉栓塞术(PTVE)治疗肝硬化上消化道出血的辅助作用。方法52例超声引导下PrrvE作为观察组，37例采用盲穿门静脉行VE作为对照组。比较2组患者穿刺成功率、穿刺时间(指确定穿刺点至导管

2、置入时间)、栓塞效果及并发症发生率。结果观察组1次穿刺成功率(73．1％)显著高于对照组(43．2％)，P<0．05具有统计学意义。观察组1次穿刺成功时间(2．3±0．6)min显著低于对照组(4．2±0．8)min，P<0．05具有统计学意义。观察组栓塞成功率(100％)显著高于对照组(86．5％)，P<0．05具有统计学意义。观察组并发症发生率低于对照组。结论超声引导对PTVE具有重要的辅助作用，能准确判断门静脉位置，增加了穿刺成功率，提高了穿刺速度。关键词]经皮肝胃门静脉栓塞术；超声引导；肝硬化；上消化道出血[

3、中图分类号]R657．31；R573．2[文献标识码]A[文章编号]1672—5042(2013)06-0652-02AuxiliaryefectofultrasonicguidanceforpercutaneoustranshepaticvaricesembolizationLIJing—song，ZHANGJun-wen，LIUQiang(DepartmentofMedicine，People’sHospitalofEconomic&TechnologyDevelopmentztmeofShuangqiaoinD

4、azuCounty，DazuChongqing400900)Abstract：ObjectiveToexploretheauxiliaryeffectofuhrasonicguidanceforpercutaneoustranshepaticvaricesembolization(VE)forthetreatmentofhemorrhageofuppergastrointestinalwithcirrhosis．MethodsFifty—twopatientsarrangedPTVEbyultrasonicguida

5、ncewereconsideredasobservationgroup．and37patientsarangedPTVEbyblindparacentesiswereconsideredascontrolgroup．Theparacentesissuccessratio，timeofparacentesis，resultsandrateofcomplicationsinthetwogroupswerecompared．ResultsTheachievementratioofone—timepunctureinobse

6、rvationgroup(73．1％)wassignificantlyincreasedthanthatincontrolgroup(43．25)．Thedifferenceswerestatisticallysignificant(P<0．05)．Thetimeofparaeentesisinobservationgroup(2．3±0．6)nfinwasshorterthanthatincontrolgroup(4．2±0．8)min．Thedifferenceswerestatisticallysignific

7、ant(P<0．05)．Therateofembolizationrateinobservationgroup(100％)wasobviouslyhigherthanthatincontrolgroup(86．5％)，thedifferenceswerestatisticallysignificant(P<0．05)，andtherateofcomplicationswaslessthanthatincontrolgroup．ConclusionTheuhrasonicguidanceplaysanimportant

8、assistantrolesforVE．itishelpfultodeterminethelocationofportalveinandincreasetheparacentesissueceedratioandspeed．Itissafeanddeservedtobespread．Keywords：percutaneoustranshepat