Роль длительной внутрипортальной катетерной терапии в комплексном эндоваскулярном лечении больных с портальной гипертензией

Аннотация

Subjects of research: 148 patients with the portal hypertension, who undergone transhepatic embolization of bleeding varicose veins of the esophagus and stomach. In 83 patients, endovascular interventions were followed by intraportal catheter therapy. Purpose of work: improving results of treatment of patients with a portal hypertension by means of optimization of intraportal catheter therapy in a complex endovascular interventions. Methods of research: clinical, laboratory and instrumental methods (ultrasound, endoscopy, endovascular) were applied. The results obtained and their novelty: the dominating role of progressing hepatic insufficiency is pointed out in a thanatogenesis of endovascular hemostasis of bleeding from varicose veins of an esophagus and a stomach in patients with portal hypertension. For the first time, necessity of intraportal catheter infusion and the technique of carrying it out in patients with the aforementioned pathology was shown. Practical value: Application of prolonged intraportal catheter therapy for the patients, bleeding from varicose veins of an esophagus and a stomach along with other endovascular interventions allows to achieve a reduction in frequency of progression of liver and kidney insufficiency in early post-embolization period from 64,6 % to 35,3 % and to reduce mortality from 50,7 % to 11,7 %. Degree of embed and economic effectivity: Practical points of this project were applied to emergent surgery department of the Tashkent Medical Academy and used in the teaching curriculum of 5-7 years medical students. Field of application: Emergent surgery.