急性胃肠道出血的介入治疗

Interventional therapy for acute gastrointestinal hemorrhage

目的探讨介入治疗急性胃肠道出血的临床应用价值。方法15例急性胃肠道出血患者常规行腹腔干、肠系膜上动脉及肠系膜下动脉DSA造影,发现阳性征象者12例,分别超选择病变血管,并采用栓塞剂或药物灌注治疗。其中,使用明胶海绵栓塞6例,明胶海绵加弹簧钢圈1例,海藻酸钠(KMG)颗粒加弹簧钢圈2例;垂体后叶素灌注3例;3例造影阴性患者未给予治疗。结果本组病例均无严重手术并发症,栓塞的9例患者中,1例Meckel憩室患者于术后3d再次出血,其余8例均一次性止血成功;另3例垂体后叶素灌注病例术后仍有反复出血症状。结论介入栓塞治疗是处理急性胃肠道出血的一项简便、微创的有效措施。

Objective To investigate and evaluate the efficacy of interventional therapy on patients with acute gastrointestinal hemorrhage. Methods Fifteen patients with acute gastrointestinal hemorrhage received celiac arteries, superior mesenterie arteries and inferior mesenterie arteries angiography. Nine hemorrhage eases definitely diagnosed were embolized with gelfoam particles, gelfoam particles plus coils, KMG particles plus coils respectively after superselective catheterization. Three eases were given hypophysin. Another three angiography negative cases were untreated. Result No rebleeding, intestinal isehemia or necrosis were observed in all embolized cases except one Meekel divertieulosis patient. Hypophysin treated eases all bleeded again. Conclusion Interventional therapeutics especially embolization is effective and safe to control acute gastrointestinal hemorrhage.