山莨菪碱药物血管造影在消化道出血诊断中的应用

Pharmacoangiography of Anisodamine in the Diagnosis of Gastrointestinal Bleeding

为提高血管造影对消化道出血的病变检出率，前瞻性地对１５例原因不明消化道出血患者作普通选择性血管造影及山莨菪碱药物血管造影的临床研究。其中１２例为肠系膜上动脉造影，３例腹腔动脉造影。在同一患者，采用相同的造影剂量、注射速率、摄片片序。经双盲法测量比较，显示山莨菪碱药物血管造影比普通血管造影动脉管径增粗，自身对照比较ｔ检验Ｐ值＜０．００１，统计学差异非常显著；还有，小动脉显示增多，实质期染色更浓密。１５例中３例普通选择性血管造影未发现异常，而山莨菪碱药物血管造影则清楚显示病理血管，提高病变检出率２０％（３／１５）。本研究显示山莨菪碱药物血管造影对于原因不明的消化道出血诊断比普通选择性血管造影有更高的敏感性。光盘检索近十年医学文献，尚未见这方面的报告。

For improving the rate of detecting the lesion of gastrointestinal bleeding with angiography,the authors studied prospectively fifteen cases of obscure gastrointestinal bleeding with selective angiography and anisodamine pharmacoangiography.Among them,12 cases were in superior mesenteric artery, 3 cases were in celiac artery. In same patient,the same amount of contrast medium,injection rate and same program of the film taken. It was showed that the diameter of arteries was wider(P<0. 001, very significant difference), the small arteries were more and the parenchymal stain was denser with anisodamine pharmacoangiography than with selective angiography.Pathological vessels which were foundin 3 cases in anisodamine pharmacoangiography were not found in selective angiography. The detecting rate 20%(3/15) was improved. It showed that the sensitivity with anisodamine pharmacoangiography was higher than with selective angiography in gastrointestinal bleeding.