Abstract: Objective To evaluate the application value of percutaneous transsplenic varices embolization （PTSVE） in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. Methods Sixteen schistosomiasis cirrhosis patients （12 males and 4 females） with portal hypertension complicated with esophageal and upper gastrointestinal hemorrhage were selected as the investigation subjects， all the patients had been treated by esophageal vein ligation and sclerotherapy， but with bleeding again post?operation. The patients were treated by PTSVE under the guidance of X?ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition， the patients received PTSVE were reexamined with abdominal CT one month post?operation， and the degrees of varices were compared before and after PTSVE. Results Fourteen cases （87.50%） were successfully treated with PTSVE. Two cases （12.50%） failed， and one case had an abdominal bleeding 1 week post?operation. The abdominal CT showed the degrees of esophageal varices （P < 0.001）， esophageal vein （P <0.001） and gastric varices （P < 0.001） were significantly decreased in the patients who received PTSVE one month after the operation. Conclusions PTSVE is a safe and effective method in the treatment of upper gastrointestinal hemorrhage in the patients with schistosomiasis cirrhosis. PTSVE is especially suitable for the patients with severe liver cirrhosis， significantly bordered liver split， and bared main portal vein and even the branches.

Key words: Schistosomiasis cirrhosis； Percutaneous transsplenic varices embolization （PTSVE）； Upper gastrointestinal hemorrhage； Portal hypertension； Esophageal and gastric varices； Embolization

摘要： 目的 探讨经皮穿脾食管胃底静脉栓塞术（PTSVE）在治疗血吸虫病肝硬化上消化道出血中的应用价值。方法 以血吸虫病肝硬化门脉高压合并食管胃底静脉曲张破裂出血患者16例（均为食管静脉套扎及硬化治疗术后再次出血患者）为研究对象，其中男12例，女4例。所有病例在X线透视引导下，实施PTSVE术。术后观察手术成功率、并发症发生率，术后1月复查CT，比较患者治疗前后静脉曲张程度。结果 14例（87.50%）患者PTSVE术取得成功，均获有效止血；2例（12.50%）失败；1例术后1周出现腹腔出血。术后1月复查CT，经评估显示患者食道静脉（P < 0.001）、食道旁静脉（P < 0.001）和胃底静脉（P < 0.001）曲张程度均较治疗前明显降低。结论 PTSVE治疗血吸虫病上消化道出血是安全有效的方法，该方法特别适合肝硬化严重，肝裂明显增宽，门静脉主干甚至分支裸露者。

关键词: 血吸虫病肝硬化；经皮穿脾食管胃底静脉栓塞术；上消化道出血；门静脉高压；食道胃底静脉；栓塞