血管造影诊断及介入治疗不明原因消化道出血的临床研究

目的研究不明原因消化道出血数字减影血管造影检查(DSA)与介入治疗的方法及临床应用价值。方法选择不明原因消化道出血25例行DSA检查,通过显示造影剂外溢、病理血管和肿瘤染色确定出血的原因及部位,对出血部位行超选择动脉插管灌注垂体后叶素止血或明胶海绵栓塞治疗。结果血管造影发现病灶20例(80%),其中血管畸形12例,肿瘤5例,小肠憩室3例。介入治疗20例,均先应用垂体后叶素灌注止血,即时止血14例,止血率70%;6例未能即时止血者进行介入栓塞治疗,5例即时止血,1例术后24小时出血停止。结论DSA检查及介入治疗不明原因消化道出血具有重要的诊断和治疗价值。

Objective To investigate the clinical value of digital substration angiography （DSA） dignosis and interventional therapy for alimentary tract hemorrhage of unknown cause. Methods DSA was performed in 25 patients with alimentary tract hemorrhage of unknown cause. The locations and causes of hemorrhage were determined by angiography according to the demonstration of contrast medium extravasation abnomal vasculature and tumor staining. Infusion of hypophysin or embolization with spongia gelatinosa were used after superselective catheter had been inserted in the bleeding artery. Results 20 （80%） patients were positive in angiogram, 12 patients of alimentary tract hemorrhage caused by arterial venous malformation, 5 patients by tumor, 3 patients by diverticulum of small intestine. 20 patients that had been treated with infusion of hypophysin, 14 （70%） patients stopped bleeding immediately. 6 patients with embolization with spongia gelatinosa, 5 patients stopped bleeding immediately and 1 patient stopped bleeding after 24 hours. Conclusion DSA and interventional therapy have important value in diagnosis and treatment of patients with alimentary tract hemorrhage of unknown cause.