介入诊疗急性动脉性消化道大出血

Interventional diagnosis and theraphy in acute massive gastrointestinal arterial hemorrhage

目的探讨急性动脉性消化道大出血介入诊疗的临床应用价值。方法对39例急性动脉性消化道大出血患者行DSA检查,对38例出血征象阳性的患者中37例采用明胶海绵颗粒配合微弹簧圈进行介入栓塞治疗。结果 39例动脉造影中38例出血征象阳性,主要表现为对比剂外溢。接受栓塞治疗的37例中,止血成功36例(其中3例行第2次栓塞),均未发生与介入栓塞相关的严重并发症。最终2例患者转剖腹探查手术。结论介入技术是急性动脉性消化道大出血安全、有效的诊疗手段,能快速明确出血动脉及部位,并迅速有效控制出血。

Objective To explore the clinical value of the angiographic diagnosis and the effectiveness of transcatheter therapy in acute massive gastrointestinal arterial hemorrhage. Methods DSA were performed in 39 patients with acute massive gastrointestinal arterial hemorrhage and 37 cases of 38 patients were found with positive signs of bleeding, then in- traarterial embolization with gelatin sponge particles and coil was applied on them after surperselective catheterization of the bleeding branch artery. Results Totally 38 patients were confirmed with positive signs of bleeding during the examination, the signs showed that the contrast dye spilled into the alimentary canal. 36 patients of the 37 intraarterial embolization cases were successfully hemostasised （3 cases received embolization twice） and no serious complications related to the interven- tional management occured. Two patients were transferred to the laparotomy procedure. Conclusion The interventional radiology is safe and effective for diagnosis and treatment of acute massive gastrointestinal arterial hemorrhage, which is helpful to quickly find out the bleeding arteries, and quickly and effectively make the haemorrhage under control.