选择性血管造影及标记定位在动脉性下消化道出血中的临床应用价值

Value of selective angiography and placement of localizing mark in arterial hemorrhage of the lower digestive tract

目的:探讨选择性血管造影在动脉性下消化道出血中的诊断价值和导管、导丝定位对外科手术的指导意义,以减少手术的盲目性。方法:分析25例动脉性下消化道出血血管造影表现,对其中18例通过导管、导丝标记定位,并行急诊或择期手术。结果:25例动脉性下消化道出血患者经选择性血管造影检查,23例发现病变,阳性率为92%;18例标记定位者中13例急诊手术、5例择期手术证实均准确定位,定位准确率为100%。本组无肠缺血、坏死等并发症发生。结论:血管造影是诊断动脉性下消化道出血的最有效的方法,放置导管、导丝定位标记能帮助外科医生顺利寻找出血部位并切除出血的原发病变,且无并发症,是一种较好的手术定位方法,值得临床推广应用。

Objective： To explore the value of selective angiography in the diagnosis of arterial hemorrhage of the lower digestive tract and the value of keeping the mark of catheter or guide wire in guiding the surgery, and to decrease the blind-ness in surgical operation. Methods： The angiographic features in arterial hemorrhage of the lower digestive tract were analyzed in 25 cases, and in 18 cases of which, the mark of catheter or guide wire was placed simultaneously as localizing mark. Result： In 25 cases of arterial hemorrhage of the lower digestive tract, positive angiographic features were displayed in 23 cases, the accuracy rate is 92%; In 18 cases （emergency operation in 13 cases, selective operation in 5 cases） of keeping the mark of catheter or guide wire in place, the bleeding site were all accurately discovered, the rate of localization is 100%. No complications of intestinal ischemia and necrosis resulting from the placement of localizing mark were found during operation in 18 patients. Condusion： Selective angiography is the best effective method in diagnosis of arterial hemorrhage of the lower digestive tract. Placement of localizing mark of catheter or guide wire can be of help to the surgeon in finding the bleeding site and resecting primary affection of hemorrhage successfully without complication. It is a better localizing method and should be widely used.