血管内栓塞术治疗急性消化道大出血

Intravascular embolizayion in treatment of huge eliminatory tract haemorrhagia

目的：探讨血管内栓塞术在急性消化道大出血的临床应用。方法回顾性分析40例急性消化道大出血临床及影像学资料，其中胃左动脉出血10例，胃十二指肠动脉出血13例，肠系膜上动脉出血5例，肠系膜下动脉出血2例，脾动脉出血2例，肝动脉出血8例，经股动脉常规穿刺插管，分别行 DSA 造影，包括腹腔动脉，肠系膜上动脉，肠系膜下动脉，膈下动脉等，发现可疑出血点进一步超选择造影，明确出血动脉后，选择适宜的栓塞材料立即栓塞治疗，术后严密观察生命体征，一旦有变化再次造影栓塞。结果40例患者中，一次栓塞成功38例，2例2次栓塞成功。术后随访3～6个月，未出现复发及严重并发症。结论血管内栓塞术治疗急性消化道大出血，迅速，准确、安全有效。

Objective To evaluate the clinical application of vascular embolization in acute gastrointestinal bleeding . Methods There were 40 cases with acute gastrointestinal bleeding ,which included 10 cases with gastric artery bleeding , 13 cases with gastroduodenal artery bleeding ,5 cases with superior mesenteric artery bleeding ,2 cases with inferior mes‐enteric artery and splenic artery bleeding respectively ,and 8 cases with hepatic arterial bleeding .After conventional femo‐ral artery catheterization ,digital subtraction angiography （DSA） was performed ,including the celiac artery ,superior mes‐enteric artery ,inferior mesenteric artery ,and inferior phrenic artery .After identification of suspicious bleeding ,arteries were immediately embolized with appropriate embolic materials .Results Among the 40 patients ,38 cases were succeeded with one embolization ,but 2 cases under went two times surgery .Patients were followed up for three to six months and there were no severe complications .Conclusion Embolization treatment is a rapid ,safe and effective method for acute gastrointestinal bleeding .