超选择动脉栓塞术治疗动脉性消化道出血

Superselective intraarterial embolization in treating gastrointestinal hemorrhage

目的讨论超选择动脉栓塞术对急性消化道出血的治疗作用。方法对31例急性消化道出血患者行动脉造影,发现出血征象时进行超选择插管并采用钢圈配合明胶海绵颗粒进行栓塞治疗。结果动脉造影表现为对比剂外溢,假性动脉瘤,血管畸形,肿瘤染色等。栓塞治疗30例,止血成功23例(其中7例行第2次栓塞),成功率76.7%。最终转为外科手术10例。结论超选择动脉栓塞术可有效治疗动脉性消化道出血,是外科治疗的重要补充措施。

Objective To evaluate the effect of superselective intraarterial embolization in treating acute massive gastrointestinal hemorrhage. Methods Thirty cases of acute massive gastrointestinal hemorrhage were treated by superselective intraarterial embolization. Mieroeatheter was used in all cases. All the target vessels were embolized by mieroeoil and geffoam particles. Results Extravasation of contrast media on anglograms and the direct sign of bleeding were observed in majority of the cases, while others included pseudoaneurysm, arterio-venous shunt, and tumoral stain. Successful hemostasis was achieved in 73 cases （including 7 with secondary embolization）, with a success rate of 76.7%. Ten cases were eventually turned to surgery. Conclusion Superseleetivc intraarterial embolization is effective and reliable in treating acute massive gastrointestinal hemorrhage, should be an important adjunct for surgery.