动脉性消化道出血患者介入治疗后复发情况及原因分析

Recurrence of Gastrointestinal Bleeding after Interventional Treatment and Its Reasons

目的探讨经血管内介入治疗消化道出血后复发的原因及预防措施。方法 72例消化道出血患者根据数字减影血管造影(DSA)结果选择介入治疗方式,39例进行栓塞治疗,33例采用单纯止血药物灌注治疗,所有患者随访1个月,对出血复发的患者均重复行介入治疗。结果栓塞组39例患者在栓塞后出血均停止,但有2例(5.2%)复发;灌注血管收缩药物组治疗后25例患者出血停止,有11例(44.0%)复发,两组复发率差异有统计学意义(P=0.001)。结论动脉性消化道出血复发的原因包括原发疾病的进展、造影的阳性率及操作技术,认识消化道出血患者介入治疗后复发的原因对预防复发具有重要意义。

Objective To investigate the reasons for recurrence of gastrointestinal hemorrhage（GIH） after endovascular interventional treatment and its preventions.Methods Seventy-two GIH patients chosed interventional treatments,based on digital subtraction angiography（DSA）.Thirty-nine had embolization（E group）,33 had simple hemostatic drug infusion therapy（HDIT group）.Follow-up lasted 1 month.Interventional treatment was repeated in patients with recurrence of GIH.Results After interventional therapy,bleeding stopped in 39 of E group,2（5.2%）had recurrence,and in 25 of HDIT group,11 had recurrence（44.0%）.The difference was significant（P=0.001）.Conclusion The causes of GIH recurrence included deterioration of primary diseases,positive rate of DSA and its operational techniques.Understanding the reasons for GIH after interventional therapy is of importance in preventing GIH recurrence.