数字减影血管造影联合垂体加压素在非肿瘤性小肠出血中的临床应用

The clinical application of DSA and Vasopression in nontumorous small intestinal hemorrhage

目的探讨数字减影血管造影联合垂体加压素在非肿瘤性小肠出血中的临床应用。方法对9例经临床证实非肿瘤性小肠出血的DSA影像资料进行回顾性分析,所有患者均用Seldinger法行肠系膜上动脉插管造影和垂体加压素治疗,全部患者经2周,3月、6月及1年随访。结果 DSA显示出血直接征像4例,出血间接征像2例,2例同时具有直接征像和间接征像,无阳性发现1例。用垂体加压素治疗后,3个月及6个月内内无1例出血,1年后检出大便隐血阳性2例,经内科保守治疗好转,随访未见小肠坏死或梗阻。结论 DSA血管造影对非肿瘤性性小肠出血的定位、定性诊断有肯定的价值,联合垂体加压素治疗,证实这是一种有效、安全、微创的方案。

Objective To evaluate the clinical application of digital subtraction angiography（DSA） and vasopression in nontumorous small intestinal hemorrhage（NSIH）.Methods The DSA data of 9 cases of NSIH were analyzed retrospectively.The cases of bleeding in all the patients were confirmed by clinic.They were performed angiography with Seldinger＇s technique through superior mesenteric artery and treatments of vasopression.The follow-up in all cases was 2weeks,3months,6months and 1year respectively.Results 4cases demonstrated direct signs of hemorrhage,2cases of indirect signs of hemorrhage and 2cases with both of the signs.1case was negative sign.After treatments,There was not hemorrhage in 3months and 6months.2cases of hemorrhage were revealed after 1year and were cured by conservative therapy.Follow-up of patients did not find small intestine necrosis or obstruction.Conclusion DSA is very helpful for determining the location and character of in NSIH,confirming an effective,safe and mini-invasive procedure with vasopression.