Combined Application Of TIPS Lauromacrogol GCVE In The Treatment Of Portal Hypertension Esophageal And Gastric Fundus Varices Of Curative Effect Analysis

ObjectiveEffect of TIPS combined application of lauromacrogol gastric coronary veinembolization (GCVE) in treatment of portal hypertension and esophageal varices ofpreoperative and postoperative portal vein hemodynamics, esophageal and gastricfundus changes, degree of the varices rebleeding rate and postoperative complications,to explore the safety, feasibility and clinical efficacy of TIPS and lauromacrogol GCVEcombination.MethodsLauromacrogol GCVE in the treatment of portal hypertension and esophageal varices inpatients with clinical data from2010April to2013April in the First Affiliated Hospitalof Dalian Medical University in interventional radiology department for22consecutivepatients underwent TIPS combined application of poly were analyzed retrospectivelyand follow-up of patients, including preoperative portal vein hemodynamics changes,esophageal varices degree, postoperative bleeding, rebleeding rate and postoperativecomplications.Results22cases of liver cirrhosis with portal hypertension and esophageal varices were treatedwith TIPS and intraoperative application of lauromacrogol GCVE treated patients, thesuccess rate was100%, no intraoperative deaths. Comparative analysis of preoperativeand postoperative portal vein pressure, diameter, blood flow velocity, portal veinpressure from36.8土5.3cmH2O before operation to25.3土3.3cmH2O after,(p=0.03);the diameter of the portal vein from1.71土0.8cm before operation to1.30土0.5cm,(p=0.04); portal vein blood flow velocity by43.4土10.7cm/s before operation to11.8土3.9cm/s,(p=0.01), contrast differences were statistically after operation. Insidediameter of splenic vein before operation,1.15土0.03cm after1.03土0.05cm,(p=0.06), before and after surgery compared no significant difference. Endoscopic follow-up datashows, before and after operation of esophageal and gastric varices (light, respectively,in severe) from preoperative0,9,13cases were improved after operation14,7,1cases,including21cases with different degrees of improvement, improvement rate was95.5%.There were2cases of recurrent hemorrhage of digestive tract in this group of patients (1cases at7months after the operation,1cases at16months after the operation), the rateof rebleeding was9.1%. No recurrent hemorrhage of digestive tract in20patients at theend of the follow-up.ConclusionCombined application of TIPS lauromacrogol GCVE in the treatment of portalhypertension and esophageal varices can effectively decrease portal pressure, recentbleeding rate and postoperative esophageal and gastric varices improvement rate weremore obvious, is the effective method in treatment of portal hypertension and varices ofesophagus and gastric fundus. During TIPS GCVE using lauromacrogol combined coilembolization has good immediate hemostatic effect, can also take into account theembolization effect of immediate and long-term, postoperative esophageal gastricfundus variceal recurrence rate and rebleeding rate is low. TIPS operation at the sametime lauromacrogol GCVE treatment of cirrhotic portal hypertension andgastrointestinal hemorrhage is a safe and effective treatment method, and has a certainpopularization value.