消化道出血的介入治疗

Interventional therapy for digestive tract hemorrhage

目的:探讨消化道出血经导管介入治疗的临床价值。方法:经DSA诊断的上消化道出血5例,4例采用立止血+明胶海绵栓塞,1例仅灌注立止血。下消化道出血14例,4例采用立止血+明胶海绵栓塞,10例仅灌注立止血。结果:动脉栓塞治疗的病例,止血率为100%,未出现严重并发症;灌注立止血的24h内止血率为80%,2例48h后再出血。结论:经动脉栓塞和灌注立止血治疗消化道出血是安全有效的止血方法,无明显副作用,在无法行靶血管栓塞的情况下,局部注入立止血也是有效可行的方法。

Objective： To study the clinical value of interventional therapy for digestive tract hemorrhage. Methods： Upper digestive tract hemorrhage were dignosed in 5 patients,4 cases underwent infusion reptilase and embolization with gelfoam, 1 case with infusion of reptilase. Lower digestive tract hemorrhage were dignosed in 14 patients, 4 cases underwent infusion reptilase and embohzafion with gelfoam, 10 cases with infusion of reptilase. Results： In 8 cases accepted arterial embolization, the stoped bleeding immediately occurred in 100% ; 11 cases perfusion of reptilase, the stoped bleeding in 24h occurred in 80%, bleeding recurrence in 2 cases. All cases without severr complication. Conclusion：To treat the digestive tract bleeding by arterial embolization and perfusion reptilase are safe and effective hemostatic ways, when the target bleed artery is inaccessible, local intraluminal infusion with repfilase is an acceptable option.