下消化道出血的诊断及术中定位方法(附22例报告)

Diagnosis and intraoperative localization of hemorrhage in lower digestive tract(a report of 22 cases)

目的 探讨原因不明的下消化道出血的术前诊断及术中定位方法。方法 采用选择性腹腔动脉造影对 2 2例原因不明的肠道出血病例进行术前诊断 ,并在选择性腹腔动脉造影诊断的基础上 ,进一步对出血分支动脉行超选插管 ,置入一小段导引钢丝作为手术定位标记及缓解急性出血期出血。结果 2 2例病人术前全部得到定性及定位诊断 ,并置标记物 ,其中小肠恶性肿瘤 8例、肠道血管畸形 14例 ,术中均准确找到标记物 ,从而获得满意的治疗效果。结论 选择性腹腔动脉造影及置标记物的方法 。

Objective To study the methods of preoperative diagnosis and intraoperative localization for hemorrage of lower digestive tract with unknown causes. Methods Twenty two cases of intestine hemorrage underwent selective celiac arteriography for making preoperative diagnosis. Bleeding vessel was further identifiied by extraselective catheterising and placed a guide wire as an marker for searching the bleeding during operation and to mitigate the hemorrage. Results 22 cases (8 with malignant tumor of small intestine and 14 with intestinal vessel malformation) were diagnosed by means of localization and determination and placed with marker, so satistactory curative efficacy was made.Conclusions Selective celiac ateriography and marker placement is an effective and accurate technique for diagnosis of acute intractable digestive hemorrage before operation and for intraoperative localization of bleeding.