应激性溃疡大出血DSA表现及介入治疗的临床价值

The Clinical Value of DSA Findings and Interventional Treatment of Massive Hemorrhage of Stress Ulcer

目的:探讨应激性溃疡大出血的数字减影血管造影(DSA)表现及介入治疗的临床应用价值。方法:2013年10月至2014年2月期间,运用Seldinger股动脉穿刺法,对30例应激性溃疡大出血患者进行选择性动脉造影术,待出血部位明确后,应用明胶海绵颗粒及弹簧圈,进行动脉栓塞治疗,通过对治疗效果的分析评价,探讨应用价值。结果:30例应激性溃疡大出血患者中,24例经DSA检查明确出血部位,经介入治疗后成功止血。患者术前与术后第3天比较,血红蛋白、红细胞压积、血压均明显升高,心率降低,统计均有明显差异(P<0.05)。结论:DSA检查对于应激性溃疡大出血的诊断和治疗,具有较高的临床参考价值,动脉栓塞介入治疗应激性溃疡大出血,具有操作简便、疗效显著等特点,值得临床推广。

Objective：To study the clinical value of digital subtraction angiography （ DSA） findings and interventional treatment of massive hemorrhage of stress ulcer .Mte hod：30 cases of massive hemorrhage of stress ulcer in our hospital from Oct .2013 to Feb.2014 were examined by the selective DSA by the Seldinger femoral artery puncture .After certaining the bleeding site , the massive hemorrhage were treated by the arteri-al embolization using the gelfoam and coils .Through analysis and evaluation of therapeutic effect , explored the application value .Result：24 cases of 30 patients with massive hemorrhage of stress ulcer were certained the hemorrhage site , received the arterial embolization treatment , and then completed the successful hemo-stasis.Patients with preoperative and postoperative 3 days, hemoglobin, red blood cell pressure product were significantly elevated.Blood pressure,heart rate decreased , statistics have obvious difference （P 〈0.05）. Conclusion：The DSA examination has the important clinical reference values of the diagnosis and treatment for massive hemorrhage of stress ulcer .The arterial embolization interventional treatment has the characteris-tics of simple operation and significant efficacy , and is worthy of clinical promotion .