摘要
目的:探讨经微导管栓塞灌注治疗动脉性消化道大出血的效果及安全性。方法:选取2010年1月—2016年12月我院收治的消化道大出血患者21例,行数字减影血管造影(DSA)明确诊断为动脉性消化道出血,对其中17例患者实施了经微导管血管栓塞,4例进行了血管加压素治疗,栓塞材料使用微弹簧钢圈、明胶海绵与PVA颗粒。结果:21例患者中,发现对比剂外溢的直接出血征象者8例,有间接出血征象者7例,DSA检查阳性率71.4%(15/21)。17例患者实施了血管栓塞治疗,其中13例出血停止,4例出血量减少;4例灌注血管加压素治疗,2例出血量减少,2例无效,总有效率90.5%(19/21)。所有患者未见胃肠道坏死等严重并发症。结论:经微导管栓塞灌注治疗动脉性消化道大出血安全、有效,具有较大临床应用价值。
Objective:To investigate the effect and safety of embolization or infusion therapy by microcatheter for acute arterial gastrointestinal hemorrhage.Methods:From January2010to December2016,21patients with acute gastrointestinal bleeding diagnosed by digital subtraction angiography(DSA)were performed by interventional therapy.17patients were treated with super-selective embolization and4with infusion of vasopressin by micro-catheter.The embolic material included microcoils,gelatin sponge and PVA particles.Results:Among the21patients,the DSA examination positive rate was71.4%(15/21).Of the17patients who were treated with the implementation of endovascular embolization by micro-catheter,the bleeding was stopped in13cases,a reduction of the amount of bleeding was observed in the other4cases.Of the4patients who received micro-catheter infusion of vasopressin treatment,the amount of bleeding reduced in2cases while the other2showed no improvement.As such,the total efficiency of both procedures was90.5%(19/21).All patients showed no serious complications of gastrointestinal necrosis.Conclusion:The embolization or infusion by micro-catheter offers a safe and effective therapy for patients with refractory gastrointestinal arterial bleeding.
作者
黄树圭
李军
武兴杰
方萍
邓军
Huang Shugui;Li Jun;Wu Xingjie;Fang Ping;Deng Jun(Department of Interventional Radiology, The First Affiliated Hospital of Guangdong University of Pharmacy, Guangzhou 510080, China;Department of Interventional Radiology, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510288, China)
出处
《中华介入放射学电子杂志》
2017年第3期153-156,共4页
Chinese Journal of Interventional Radiology：electronic edition
关键词
消化道出血
血管造影
栓塞
介入放射学
Gastrointestinal hemorrhage
Angiography
Embolization
Interventional radiology
