介入诊断和栓塞治疗在消化道出血中的应用价值

Clinical value of interventional diagnosis and embolization therapy in gastrointestinal hemorrhage

目的:探讨介入诊断和栓塞治疗在消化道出血中的临床应用及价值.方法:对29例消化道出血病例进行数字减影血管造影(digital subtraction angiography,DSA),并对16例发现出血征象者采用明胶海绵配合弹簧圈进行栓塞治疗.结果:29例造影中发现出血阳性征象20例,占69%(20/29),其中15例表现为直接阳性征象,5例表现为间接阳性征象.共有16例接受栓塞治疗,14例止血成功,30 d内无复发出血,无肠缺血坏死等并发症,最终成功率87.5%(14/16).2例失败病例转而接受外科手术治疗.结论:选择性动脉造影对消化道出血的定位和诊断有重要价值,介入栓塞治疗止血迅速、安全有效.

AIM： To assess the clinical value of interventionaldiagnosis and therapy in gastrointestinal hemorrhage.METHODS： Twenty-nine patients with gastrointestinal hemorrhage underwent digital subtraction angiography（DSA）. When positive signs of bleeding appeared, 16 patients underwent embolization with coils and gel foam after superselective catheterization.RESULTS： The positive signs were observed in 20 of 29 cases, including direct positive signs in 15 cases and indirect positive signs in 5 cases. Transcatheter arterial embolization was carried out in 16 patients, and successful hemostasis was achieved in 14 cases, with a success rate of 87.5%（14/16）. The two failed cases were treated by surgical operation. No rebleeding or intestinal ischaemia was observed in 30 days.CONCLUSION： Selective angiography and intra-arterial embolization are effective and safe in the diagnosis and therapy of gastrointestinal hemorrhage.