选择性血管造影对“不明原因”消化道出血的诊断

Selective Angiographic Diagnosis of Gastrointestinal Hemorrhage of Unknown Reason

目的 :探讨选择性血管造影对不明原因消化道出血的诊断价值。方法 :2 8例反复不明原因消化道出血患者 ,经Seldinger’s法靶动脉插管PUCK造影 ,其中 2 4例造影阳性者 ,经外科手术治疗 ,并将血管造影表现与手术病理对照。 结果 :定位诊断率 87.5 % (2 1/2 4) ,与手术病理诊断的符合率为 75 % (18/2 4) ,病变性质为 :肿瘤性病变 6例 ,血管畸形 15例 ,麦克尔氏憩室 2例 ,克隆氏病 1例。结论 :选择性血管造影对不明原因的消化道出血的定位、定性诊断有肯定的价值。

Objective:To evaluate the diagnostic value of selective angiography gastrointestinal hemorrhage of unknown reason. Methods:28 patients with chronic gastrointestinal recurrent hemorrhage of unknown reason were examined. They were under Puck angiography with Seldinger's technique. Among them, 24 patients with positive signs received surgical treatment, and were correlated with pathology. Results:The accuracy of localization was 87.5%(21/24) and the coincident rates with the operation or pathology were 75%(18/24). In all patients, 6 cases were of tumor, 15 cases, of vascular malformation; 2 cases of Meckel's diverticulum and 1 case of Crohn's disease. Conclusions:Selective angiography is very helpful for determining the location and character of unknown reasoned chronic gastrointestinal hemorrhage.