关键词: 多层螺旋CT, 门静脉造影, 食管胃底静脉曲张出血, 预后, 应用价值

Abstract: Objective To analyze the application value of multi-slice spiral computed tomography (CT) portal venography over perioperative period in cirrhotic patients with esophagogastric variceal bleeding.Methods A total of 52 cirrhotic patients with esophagogastric variceal bleeding admitted to our hospital from January 2015 to December 2018 were enrolled.All of these patients were treated with the combination of transjugular intrahepatic portosystemic shunt (TIPS) and left gastric vein embolization.Multi-slice spiral CT portal venography was used for perioperative follow-up,and its application value was evaluated.Results Before operation,48 patients (92.3%) had gastric coronary varices,19 patients (36.5%) had short gastric varices,49 patients (94.2%) had esophageal varices,and 10 patients (19.2%) had paraumbilical varices.Portal pressure decreased from (35.3±2.2) cmH₂O before treatment to (26.1±1.9) cmH₂O after treatment,with significant difference (t=9.837,P<0.001).The follow-up at 6 months and 12 months after operation,varices disappeared and blood flow resumed in 38 patients (73.1%),varices relapsed after the improvement in 12 patients (23.1%),and varices had no improvement in 2 patients (3.8%).Within 12 months after operation,variceal rebleeding occurred in 6 patients (11.5%).Within 6 months after operation,hepatic encephalopathy was observed in 4 patients (7.69%).During 13-23 months after operation,3 patients (5.8%) died of hepatic failure.Conclusion For patients undergoing TIPS and left gastric vein embolization,multi-slice spiral CT portal venography has high clinical value in varicose veins monitoring,treatment guiding,and prognosis assessment.

Key words: Multi-slice spiral computed tomography, Portal venography, Esophageal variceal bleeding, Prognosis, Application value