摘要
目的探讨医源性上消化道出血选择性动脉造影及经导管动脉栓塞治疗的临床应用价值。方法回顾性分析2006年9月至2014年10月采用选择性动脉造影及经导管动脉栓塞治疗的45例医源性上消化道出血患者临床资料，总结治疗经验。结果45例医源性上消化道出血患者中40例为外科手术后出血．5例为介入手术后出血，其中1例因胰腺癌伴肠梗阻接受十二指肠支架植入后引起出血。4例因胆管癌伴阻塞性黄疸接受经皮经肝胆管引流术后引起出血。选择性血管造影及经导管动脉栓塞治疗后41例完全止血，4例复发出血，其中1例胰腺癌伴肠梗阻患者于栓塞术后5d大出血死亡，3例接受再次栓塞治疗完全止血。所有患者术后未发生胃肠道缺血、坏死等严重并发症。术后随访6个月-8年，未再发出血。结论选择性血管造影对于医源性上消化道出血有较好的诊断效果，经导管动脉栓塞治疗是安全有效的治疗方法，具有较高的临床应用价值。
Objective To investigate the clinical application of selective angiography and transcatheter arterial embolization therapy in diagnosing and treating iatrogenic upper gastrointestinal hemorrhage. Methods The clinical data of 45 patients with iatrogenic upper digestive tract hemorrhage, who were admitted to authors＇ hospital during the period from September 2006 to October 2014 to receive selective angiography and transeatheter arterial embolization therapy, were retrospectively analyzed. The clinical experience was summarized. Results Among the 45 patients with upper gastrointestinal bleeding, bleeding occurring after surgery was seen in 40 and bleeding occurring after interventional procedure was found in 5. One patient with pancreatic cancer associated with intestinal obstruction developed bleeding after receiving duodenal stent implantation and 4 patients with cholangioeareinoma complicated by obstructive jaundice developed bleeding after receiving percutaneous transhepatic biliary drainage. After selective angiography and transcatheter arterial embolization therapy, complete hemostasis was obtained in 41 patients and recurrence of bleeding was seen in 4 patients. Among the 4 patients, one patient suffering from pancreatic cancer with intestinal obstruction died of massive hemorrhage in 5 days after embolization, and in other 3 patients the bleeding completely stopped after receiving embolization once again. No severe comp- lications such as gastrointestinal ischemia or necrosis occurred in all patients. During the follow-up period lasting for 6 months to 8 years, no recurrence of bleeding was observed. Conclusion For the diagnosis and treatment of iatrogenic upper gastrointestinal hemorrhage, selective angiography and transcatheter arterial embolization therapy are safe and effective, which are of higher clinical value.
出处
《介入放射学杂志》
CSCD
北大核心
2016年第2期111-115,共5页
Journal of Interventional Radiology
关键词
医源性
消化道上出血
诊断
介入栓塞
iatrogenic
upper gastrointestinal hemorrhage
diagnosis
interventional embolization
