超选择性肠系膜上动脉栓塞治疗急性消化道出血

Superselective superior mesenteric arterial embolization for acute digestive tract hemorrhage

目的 :评价超选择性栓塞肠系膜上动脉治疗急性消化道出血的可行性及安全性 ,并分析影响其疗效的因素。方法 :对16例因急性肠道出血行超选择性肠系膜上动脉栓塞的患者进行回顾性研究。为观察有无缺血和再出血情况,所有患者均临床跟踪4天～68月 (平均24.5月 ) ,另外对1例患者止血成功后第七天行胃镜检查 ,对6例成功手术后的标本进行了病理检查。结果 :16例患者均成功地进行了超选择性栓塞 ,立即止血为100 %,63 %的病人以此法作为决定性的治疗手段 ,治疗后再出血为23 %,无肠管坏死及狭窄出现。结论 :使用适当数量及合适大小的栓塞物质在肠系膜上动脉尽可能远的位置栓塞治疗急性肠道出血是安全有效的。

Objective:To study and evaluate the feasibility and safety of superselective superior mesenteric arterial embolization for treating acute digestive tract hemorrhage,and analyse the relevant factors of affecting the curative effect.Methods:A restrospective reviewwas conducted on16patients who underwent superselective superior mesenteric arterial embolization for acute digestive tract hemorrhage.All16patients were folˉlowed clinically4days to68months(mean24.5months)after embolization for the condition of ischemia or not and recurrent hemorrhage.In adˉdition,1of16cases was inspected at7days after embolization by gastroscopy,the pathologic examination in6cases was performed after successful surgical resection.Results:Transcatheter embolization achieved immediate hemostasis in all patients.63%of patients were treated in this from as a decisive treatment resort.The recurrent hemorrhage rate was23%after treatment,Intestinal infarction and stricture was not found.Conclusion:Superselective superior mesenteric arterial embolization for acute digestive tract hemorrhage is a safe and effective therapeutic method in geting into the distal site of the second branch artery of the vasa recta or further supplying the hemorrhage area with the suitable embolic agent in sort,size and quantity.