数字减影血管造影检查联合不同方法治疗急性消化道出血效果比较

Effects of DSA Combined with Different Approaches in Treatment of Acute Massive Hemorrhage of Gastrointestinal Tract

目的比较数字减影血管造影(DSA)分别联合血管内栓塞和药物灌注治疗急性消化道出血的临床效果。方法选择2011年1月—2013年12月保定市第二中心医院收治的急性消化道出血患者68例,根据介入治疗方法不同将所有患者分为两组,栓塞组(44例)采用DSA技术联合血管内栓塞术治疗,灌注组(24例)采用DSA技术联合药物灌注治疗,比较两组疗效。结果 DSA显示68例中上消化道出血28例、下消化道出血40例。两组治疗后与治疗前比较收缩压、红细胞和血红蛋白差异均有统计学意义(P<0.05),治疗后两组收缩压、红细胞和血红蛋白差异均有统计学意义(P<0.05)。治疗后24 h内,两组完全止血率比较差异有统计学意义(P<0.05)。术后随访3个月,两组有效率和复发率差异均有统计学意义(P<0.05)。结论 DSA联合血管内栓塞术治疗急性消化道出血的效果优于DSA联合药物灌注治疗。

Objective To compare the clinical effects of digital subtraction angiography （DSA） combined with intravascular embolization and intravascular perfusion in treatment of acute massive hemorrhage of gastrointestinal tract. Methods A total of 68 patients with acute massive hemorrhage of gastrointestinal tract admitted during January 2011 and December 2013 were randomly divided into the intravascular embolization group （IE group, n = 44） and the intravascular perfusion group （ IP group, n = 24）. IE group was treated with DSA combined with intravascular embolization, while IP group was treated with DSA combined with intravascular perfusion, and the clinical effects of the two groups were compared. Results DSA showed that there were 28 patients with upper gastrointestinal bleeding and 40 patients with lower gastrointestinal hemorrhage in the 68 patients. The differences of systolic blood pressure （SBP） , red blood cell （RBC） and hemoglobin （Hb） levels before and after the treatment in the two groups were statistically significant （P 〈 0. 05 ）. The differences of SBP, RBC and Hb levels after the treatment in the two groups were statistically significant （P 〈 0.05 ）. Within 24 h after the treatment the difference in total hemostasis rate of the groups was statistically significant （ P 〈 0. 05 ）. With following up for 3 months, the differences in effective rate and recurrence rate in the two groups were statistically significant （ P 〈 0.05 ）. Conclusion The DSA combined with intravascular embolization has better effect compared with that by DSA combined with intravascular perfusion in treatment of acute massive hemorrhage of gastrointestinal tract.