肠血管发育不良的血管造影诊断及标记定位（附36例报告）

Angiography Diagnosis of Intestinal Angiodysplasia and Placement of Location Mark: Report of 36 Cases

目的：肠血管发育不良是引发消化道出血的原因之一。应用血管造影诊断并同时放置标记物为外科手术定位以减少手术中的盲目性。材料与方法：选择性血管造影术前诊断３８例肠血管发育不良，其中８例放置了钢丝或造影导管作为手术定位标记，并即刻或择期手术。结果：肠血管发育不良造影表现可归纳为：①动静脉疹和静脉早显；②局部异常增多的血管丛；③局部染色浓密；④肠壁内静脉扩张、迂曲。３Ｏ例病理证实中，２例为炎症；诊断正确率为９３％。８例放置定位标记患者中，术中未见肠缺血改变。结论：选择性血管造影是目前诊断该病的最好办法，同时放置定位标记能帮助外科医师顺利寻找并切除病灶，且无并发症。该法是一全新定位方法，值得推广应用。

Objective: Intestinal angiodysplasia is one of the common causes of intestinal bleeding. The sclective angiography diagnosis with placement of mark for lesion location may decreased the blindess in surgical intervention. Materials and Methods: Sclective angiography were made in 38 patients with intestinal angiodysplasia, and in 8 of which, a segment of guide wire or catheter itself was placed simultaneously as location mark. Results: The principal angiographic features of this disease could be summarized as:①arterio-venous shunt and early appearance of drainage veins; ②focal abnormal increase of vessel clumps; ③focal dense stain; ④dilated and tortuous veins in intestinal wall.In 2 of 30 operated patients, the histological results were of inflammation, so the accuracy rate was 93%, No intestinal inchemia changes resulting from the placement of location mark were found during operation in 8 patients. Conclusion: Selective angiography is the best method in diagnosis of intestinal angiodysplasia at present.Placement of location mark can help surgeon greatly in finding and resecting the lesion successfully without complications. It is a new method and should be widely spread.