谢波, 许红, 谭玉林, 张阳, 袁牧, 杨培培. 急性消化道出血的造影诊断和栓塞治疗[J]. 蚌埠医学院学报, 2014, 38(5): 646-648.
    引用本文: 谢波, 许红, 谭玉林, 张阳, 袁牧, 杨培培. 急性消化道出血的造影诊断和栓塞治疗[J]. 蚌埠医学院学报, 2014, 38(5): 646-648.
    XIE Bo, XU Hong, TAN Yulin, ZHANG Yang, YUAN Mu, YANG Peipei. The angiography diagnosis and embolotherapy of acute gastrointestinal bleeding[J]. Journal of Bengbu Medical College, 2014, 38(5): 646-648.
    Citation: XIE Bo, XU Hong, TAN Yulin, ZHANG Yang, YUAN Mu, YANG Peipei. The angiography diagnosis and embolotherapy of acute gastrointestinal bleeding[J]. Journal of Bengbu Medical College, 2014, 38(5): 646-648.

    急性消化道出血的造影诊断和栓塞治疗

    The angiography diagnosis and embolotherapy of acute gastrointestinal bleeding

    • 摘要: 目的:探讨数字减影血管造影诊断和血管栓塞术治疗在急性消化道出血中的临床价值。方法:对30例消化道出血患者急诊给予动脉造影术,部分患者联合栓塞治疗和外科手术治疗,观察血管内造影诊断及栓塞治疗的效果。结果:30例患者血管造影中发现假性动脉瘤8例,动脉节段性狭窄3例,同时有假性动脉瘤和狭窄2例;发现动脉增粗和肿瘤染色2例;造影剂外溢9例;未见明显异常6例。24例给予血管栓塞,术后出血停止22例,有效率为91.7%。栓塞术后复发2例,复发率为8.3%;因弥漫性血管内凝血病死1例。未予栓塞直接行外科手术4例,2例为小肠间质瘤,1例为胃癌术后出血,再次手术发现残胃弥漫性出血;1例为吻合口残端瘘,手术后出血停止。2例保守治疗自动出院。结论:动脉造影和血管栓塞术是诊断和治疗消化道出血的有效方法,尤其对外科术后出血的患者阳性率更高,具有微创、安全、迅速的特点。对于部分栓塞后再出血和消化道肿瘤的患者结合外科手术可取得更好的效果。

       

      Abstract: Objective:To explore the clinical value of angiography diagnosis and embolotherapy in the treatment of acute gastrointestinal bleeding.Method:Thirty patients with acute gastrointestinal bleeding were treated with arteriography and embolotherapy,some patients were treated with operation.The effects of angiography diagnosis and embolotherapy were observed.Results:Amony 30 patients,pseudoaneurysms in 8 cases,segmental arterial stricture in 3 cases,pseudoaneurysms and segmental arterial stricture in 2 cases,vascular thickening and tumor staining in 2 cases,contrast medium extravasating in 9 cases and normal in 6 cases were found.Twenty-four patients were treated with embolotherapy,bleeding in 22 cases were controlled,the effective rate was 91.7%.The postoperative recurrence in 2 cases were found,the recurrence rate was 8.3%.One case died of disseminated intravascular coagulation.Four cases were treated with operation.Two cases were small intestinal stromal tumor.One case was postoperative bleeding of gastric cancer and diffuse hemorrhage of residual stomach was found after reoperation,one case was anastomotic leakage and bleeding stopped after operation.Two patients were discharged after conservative treatment.Conclusion:The arteriography and embolotherapy in diagnosing and treating acute gastrointestinal bleeding is micro-invasive,safe and quick,which is an effective way especially for patients with postoperative bleeding.The operation for the patients with rebleeding after embolotherapy and gastrointestinal tumor can obtain good effects.

       

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