下消化道出血的介入诊断与治疗

The interventional diagnosis and treatment for lower digestive tract bleeding

目的探讨介入方法在下消化道出血的诊断和治疗中的价值。方法对11例经过内镜及钡剂检查未明确出血原因和部位的消化道出血患者,进行选择性动脉造影,通过显示造影剂外溢,病理血管和肿瘤染色来确定出血原因及部位。同时对出血处用明胶海棉栓塞或用保留导管血管加压素灌注止血。结果全组11例,其中10例见造影剂外溢,1例同时见肿瘤染色,7例显示病理血管。1例未能明显诊断。3例用明胶海绵栓塞治疗,8例采用保留导管灌注血管加压素治疗,均达到止血效果。结论介入治疗下消化道出血,可以快速作出诊断定位,且止血效果好,见效快,并发症少,安全可靠。

Objective To study the value of interventional diagnosis and treatment for lower digestive tract hemorrhage.Methods Eleven patients with gastrointestinal tract hemorrhage were preformed with selective arteriography,after they were not definituded the location and cause of hemorrhage by endoscopy and barium meal examination,the location and cause of hemorrhage were confirmed according to showing contrast medium extravasation,the location and cause of hemorrhage were confirmed according to showing contrast medium cxtravasation,pathologic vein and tumour dyeing.At the same time,we embolized the bleeding arteria with Gelfoam or infused the bleeding arteria through the catheter with Pitntitrin forhemostasis.Results Among 11 cases, 10 cases showed contrast medium extravasation,one case didn't show exceptional.One case showed tumour dying,and 7 cases showed pathologic vein.3 cases underwent aemblization through artery with Gelfoam and 8 acses with infusion of Pitntitrin via catheter for hemorrhage. All cases achieved the effect of hemostasis.Conclusion Interventional treatment can rapidly diag- nose the location and cause of hemorrhage in lower digestive tract.It is asalf effect hemostatic technique with fewer complcation in lower digestive tract hemorrhage.