[1]常云丽,陈国裕,冯灵美,等.超声内镜引导下弹簧圈联合组织胶栓塞治疗胃静脉曲张临床价值研究进展[J].陕西医学杂志,2024,(8):1150-封3.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.031]
 CHANG Yunli,CHEN Guoyu,FENG Lingmei,et al.Research progress on the value of endoscopic ultrasound guided coils combined with tissue glue embolization in the treatment of gastric varices[J].,2024,(8):1150-封3.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.031]
点击复制

超声内镜引导下弹簧圈联合组织胶栓塞治疗胃静脉曲张临床价值研究进展
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1150-封3
栏目:
综 述
出版日期:
2024-08-05

文章信息/Info

Title:
Research progress on the value of endoscopic ultrasound guided coils combined with tissue glue embolization in the treatment of gastric varices
作者:
常云丽陈国裕冯灵美叶 静
(上海市浦东新区人民医院,上海 201299)
Author(s):
CHANG YunliCHEN GuoyuFENG LingmeiYE Jing
(Shanghai Pudong New Area People's Hospital,Shanghai 201299,China)
关键词:
胃静脉曲张 超声内镜 弹簧圈栓塞 组织胶 门脉高压
Keywords:
Gastric varices Endoscopic ultrasound Coils embolization Tissue glue Portal hypertension
分类号:
R 657.34
DOI:
DOI:10.3969/j.issn.1000-7377.2024.08.031
文献标志码:
A
摘要:
胃静脉曲张(GV)破裂出血是门静脉高压患者致死主要原因之一。目前GV的治疗方法主要包括药物治疗、内镜下治疗和介入治疗。其中,内镜下治疗是目前治疗GV的主流方案。传统内镜下治疗主要是向曲张静脉内注射组织胶,其缺点主要为内镜下曲张静脉特征观察有限和可能的远端胶栓塞。为了减少这些不足之处,近年来,内镜超声(EUS)引导下GV治疗已成为有应用前景的替代方法。EUS的独特优势在于通过使用多普勒超声识别静脉曲张,观察血流情况,采用实时可视化治疗方式,使得操作更加精准,并且不受出血导致视野障碍的影响。EUS引导下GV治疗主要包括单用组织胶注射、单用弹簧圈栓塞以及两者联合治疗。EUS相关治疗也存在不足之处,包括临床资料有限、缺乏标准化方法、技术尚未推广。现就EUS引导下GV治疗以及弹簧圈联合组织胶治疗GV的研究进展进行综述。
Abstract:
Gastric varices(GV)rupture bleeding is one of the main causes of death in patients with portal hypertension.At present,the treatment methods of GV mainly include drug therapy,endoscopic therapy and interventional therapy.Among them,endoscopic therapy is the mainstream treatment for GV.The traditional endoscopic treatment mainly involves the injection of tissue glue into varicose veins.Its disadvantages are mainly limited observation of the characteristics of varicose veins under endoscopy and possible distal glue embolization.In order to reduce these deficiencies,endoscopic ultrasound(EUS)guided treatment of GV has become an extremely promising alternative approach in recent years.The unique advantages of EUS are that it can confirm varicose veins,observe blood flow,and provide visualization of treatment in real time by using Doppler ultrasound to make the operation more precise and be not affected by visual field disturbances caused by bleeding.EUS-related treatment also has shortcomings, including limited clinical data,lack of standardized methods, and lack of popularization of the technology.This article reviews the progress in the treatment of GV under EUS guidance and the treatment of GV with coils combined with tissue glue.

参考文献/References:

[1] 聂姝常,王妙苗,程彬彬.肝硬化合并肠道功能失调的中西医结合治疗研究进展[J].陕西中医,2023,44(2):259-261,266.
[2] 范丽,张婷.拉米夫定、阿德福韦酯、恩替卡韦治疗失代偿期乙型肝炎肝硬化临床研究[J].陕西医学杂志,2019,48(7):939-941.
[3] 田莉婷,刘雪萍,李丹妮,等.加味苓桂术甘汤对脾肾阳虚型肝硬化失代偿期患者生存率的影响[J].陕西中医,2019,40(10):1373-1376.
[4] WANI Z A,BHAT R A,BHADORIA A S,et al.Gastric varices:Classification,endoscopic and ultrasonographic management[J].J Res Med Sci,2015,20(12):1200-1207.
[5] MAYDEO A,PATIL G.How to approach a patient with gastric varices[J].Gastroenterology,2022,162(3):689-695.
[6] 耿楠,马冰,陈新月,等.肝硬化门脉高压性胃病临床分析[J].中国实验诊断学,2008,12(6):753-756.
[7] ABBY-PHILIPS C,SAHNEY A.Oesophageal and gastric varices:Historical aspects,classification and grading:Everything in one place[J].Gastroenterol Rep(Oxf),2016,4(3):186-195.
[8] 中华医学会肝病学分会,中华医学会消化病学分会,中华医学会消化内镜学分会.肝硬化门静脉高压食管胃静脉曲张出血的防治指南[J].实用肝脏病杂志,2023,26(2):后插1-后插14.
[9] CHOE J W,YIM H J,LEE S H,et al.Primary prophylaxis of gastric variceal bleeding:Endoscopic obturation,radiologic intervention,or observation?[J].Hepatol Int,2021,15(4):934-945.
[10] GARCIA-TSAO G,ABRALDES J G,BERZIGOTTI A,et al.Portal hypertensive bleeding in cirrhosis:Risk stratification,diagnosis,and management:2016 practice guidance by the American association for the study of liver diseases[J].Hepatology,2017,65(1):310-335.
[11] KHAN F,TRIPATHI D.Role of early transjugular intrahepatic portosystemic stent-shunt in acute variceal bleeding:An update of the evidence and future directions[J].World J Gastroenterol,2021,27(44):7612-7624.
[12] SABRI S S,SWEE W,TURBA U C,et al.Bleeding gastric varices obliteration with balloon-occluded retrograde transvenous obliteration using sodium tetradecyl sulfate foam[J].J Vasc Interv Radiol,2011,22(3):309-316.
[13] 刘杰,闵林玲,潘金,等.经颈静脉肝内门腔静脉分流术与经皮肝穿刺胃冠状静脉栓塞术治疗肝硬化食管胃底静脉曲张破裂出血疗效对比研究[J].陕西医学杂志,2023,52(9):1191-1195.
[14] 张晓丰,张玮,于之源,等.经颈静脉肝内门体分流术后分流道失功再通肝硬化患者预后影响因素分析[J].临床肝胆病杂志,2020,36(2):338-342.
[15] CAMPOS S,POLEY J W,VAN-DRIEL L,et al.The role of EUS in diagnosis and treatment of liver disorders[J].Endosc Int Open,2019,7(10):e1262-e1275.
[16] KHAKWANI A,TRIVEDI M,AFZAL M,et al.Use of balloon occluded retrograde transvenous obliteration(BRTO)for treatment of gastric varices:A narrative review[J].Cureus,2023,15(4):e38233.
[17] 赵海英,宗晔,马海莲,等.内镜超声引导下弹簧圈联合组织黏合剂栓塞治疗合并自发分流道的胃底静脉曲张的临床研究[J].中华消化内镜杂志,2018,35(8):592-594.
[18] SABRI S S,SAAD W E A.Balloon-occluded retrograde transvenous obliteration(BRTO):Technique and intraprocedural imaging[J].Semin Intervent Radiol,2011,28(3):303-313.
[19] THIRUVENGADAM S S,SEDARAT A.The role of endoscopic ultrasound(EUS)in the management of gastric varices[J].Curr Gastroenterol Rep,2021,23(1):1.
[20] 中华医学会外科学分会脾及门静脉高压外科学组.肝硬化门静脉高压症食管、胃底静脉曲张破裂出血诊治专家共识(2019版)[J].中华消化外科杂志,2019,18(12):1087-1093.
[21] EUROPEAN ASSOCIATION FOR THE STUDY OF THE LIVER.EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J].J Hepatol,2018,69(2):406-460.
[22] FRY L C,NEUMANN H,OLANO C,et al.Efficacy,complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices[J].Dig Dis,2008,26(4):300-303.
[23] CHIRAPONGSATHORN S,MANATSATHIT W,FARRELL A,et al.Safety and efficacy of endoscopic cyanoacrylate injection in the management of gastric varices:A systematic review and meta-analysis[J].JGH Open,2021,5(9):1047-1055.
[24] TAKI S,IGUCHI M,MAEKITA T,et al.Endoscopic N-butyl-2-cyanoacrylate and ethanolamine oleate injection is equivalent to balloon-occluded retrograde transvenous obliteration for preventing gastric variceal bleeding[J].Surg Endosc,2023,37(8):6008-6014.
[25] ZARDI E M,UWECHIE V,CACCAVO D,et al.Portosystemic shunts in a large cohort of patients with liver cirrhosis:Detection rate and clinical relevance[J].J Gastroenterol,2009,44(1):76-83.
[26] 黄子殷,操寄望,肖勇,等.内镜超声引导弹簧圈栓塞联合内镜组织胶注射治疗胃底静脉曲张的回顾性研究[J].中华消化内镜杂志,2022,39(5):373-378.
[27] DEWITT J M,ARAIN M,CHANG K J,et al.Interventional endoscopic ultrasound:Current status and future directions[J].Clin Gastroenterol Hepatol,2021,19(1):24-40.
[28] 肖培光,谢正元.内镜超声评估门静脉高压性出血风险及静脉曲张复发进展[J].中国医学影像技术,2022,38(2):300-303.
[29] ROBLES-MEDRANDA C,VALERO M,NEBEL J A,et al.Endoscopic-ultrasound-guided coil and cyanoacrylate embolization for gastric varices and the roles of endoscopic Doppler and endosonographic varicealography in vascular targeting[J].Dig Endosc,2019,31(3):283-290.
[30] BHAT Y M,WEILERT F,FREDRICK R T,et al.EUS-guided treatment of gastric fundal varices with combined injection of coils and cyanoacrylate glue:A large U.S.experience over 6 years(with video)[J].Gastrointest Endosc,2016,83(6):1164-1172.
[31] MOHAN B P,CHANDAN S,KHAN S R,et al.Efficacy and safety of endoscopic ultrasound-guided therapy vs direct endoscopic glue injection therapy for gastric varices:Systematic review and meta-analysis[J].Endoscopy,2020,52(4):259-267.
[32] AL-KHAZRAJI A,CURRY M P.The current knowledge about the therapeutic use of endoscopic sclerotherapy and endoscopic tissue adhesives in variceal bleeding[J].Expert Rev Gastroenterol Hepatol,2019,13(9):893-897.
[33] ROBLES-MEDRANDA C,OLEAS R,DEL-VALLE R,et al.EUS-guided therapy of gastric varices(with video)[J].Endosc Ultrasound,2020,9(5):280-283.
[34] ROMERO-CASTRO R,ELLRICHMANN M,ORTIZ-MOYANO C,et al.EUS-guided coil vs cyanoacrylate therapy for the treatment of gastric varices:A multicenter study(with videos)[J].Gastrointest Endosc,2013,78(5):711-721.
[35] BAZARBASHI A N,WANG T J,JIRAPINYO P,et al.Endoscopic ultrasound-guided coil embolization with absorbable gelatin sponge appears superior to traditional cyanoacrylate injection for the treatment of gastric varices[J].Clin Transl Gastroenterol,2020,11(5):e00175.
[36] WANG X,YU S,CHEN X,et al.Endoscopic ultrasound-guided injection of coils and cyanoacrylate glue for the treatment of gastric fundal varices with abnormal shunts:A series of case reports[J].J Int Med Res,2019,47(4):1802-1809.
[37] BINMOELLER K F,WEILERT F,SHAH J N,et al.EUS-guided transesophageal treatment of gastric fundal varices with combined coiling and cyanoacrylate glue injection(with videos)[J].Gastrointest Endosc,2011,74(5):1019-1025.
[38] 陈明锴,丁震,肖勇,等.超声内镜联合胃镜治疗明显脾肾分流合并巨大胃静脉曲张的初步探讨[J].中华消化内镜杂志,2016,33(10):707-710.
[39] KOUANDA A,BINMOELLER K,HAMERSKI C,et al.Safety and efficacy of EUS-guided coil and glue injection for the primary prophylaxis of gastric variceal hemorrhage[J].Gastrointest Endosc,2021,94(2):291-296.
[40] ROBLES-MEDRANDA C,OLEAS R,VALERO M,et al.Endoscopic ultrasonography-guided deployment of embolization coils and cyanoacrylate injection in gastric varices vs coiling alone:A randomized trial[J].Endoscopy,2020,52(4):268-275.
[41] MCCARTY T R,BAZARBASHI A N,HATHORN K E,et al.Combination therapy versus monotherapy for EUS-guided management of gastric varices:A systematic review and meta-analysis[J].Endosc Ultrasound,2020,9(1):6-15.

备注/Memo

备注/Memo:
基金项目:上海市浦东新区卫生健康委员会学科建设特色专病计划(PWZzb2022-30)
更新日期/Last Update: 2024-08-08