急慢性下消化道出血的数字减影血管造影诊断与介入治疗

Clinical value of digital subtraction angiography in diagnosis and intervention treatment of lower gastrointestinal bleeding

目的探讨急慢性下消化道出血数字减影血管造影（DSA）影像诊断与介入栓塞治疗的临床应用。方法通过对35例急慢性下消化道出血患者行DSA造影检查，分析有无肿瘤染色、异常血管显现及造影剂外溢等影像资料，判断下消化道出血的部位及原因。对30例阳性发现者，行超选择性造影确诊并介入灌注及栓塞治疗。结果本组35例患者DSA造影发现出血30例，其中15例肿瘤，11例肠血管发育不良，4例结肠溃疡，总阳性率为85．7％（30／35）。结论DSA检查对下消化出血有定位、定性诊断。其对阳性患者行介入栓塞治疗达到止血的目的，部分患者可以根治，是一种有效、安全、微创的治疗方法。

Objective To evaluate the clinical value of digital subtraction angiography（DSA） in diagnosis and intervention treatment of acute lower gastrointatinal bleeding. Methods Thirty - five patients with acute or chronic lower gastrointatinal bleeding were examined by DSA. We analysed their DSA findings, and detected the locations and causes of bleeding depending on tumor staining, abnormal vessels and contrast overflow. The locations of bleeding were difinitively detected in 30 cases, and all 30 cases were selectively cathetered to embolize. Results Thirty of 35 patients were bleeding during the DSA, that consisted of 15 cases with tumor, 11 cases with blood vessel abnormality and 4 cases with colons ulcer. The positive incidence reached 85.7%. Conclusion DSA test is an effective method to detect the locations and causes of lower gastrointatinal bleeding, and endovascular embolization of lower gastrointatinal bleeding is a safe and effective approach, and some patients could be cured.