DSA诊断及介入治疗不明原因消化道出血的临床研究

Clinic analysis for DSA diagnosis and interventional therapy of obscure gastrointestinal bleeding

目的观察不明原因消化道出血(OGIB)应用数字减影血管造影(DSA)诊断及介入治疗的临床效果。方法选取医院收治的OGIB患者117例,按照介入治疗方式不同分为观察组(72例)行血管内栓塞术治疗,对照组(45例)行药物灌注治疗。记录DSA诊断阳性率;比较2种介入方式临床疗效、不良反应及随访6个月内复发率。结果 117例患者中,DSA检查显示,直接征象54例,间接征象47例,诊断阳性率为86.3%(101/117);观察组总有效率为94.4%,显著高于对照组的77.8%(P<0.01);观察组不良反应率为13.9%,对照组为13.3%,2组差异无统计学意义(P>0.05);随访6个月内,观察组复发率为4.2%,低于对照组的15.6%(P<0.05)。结论 DSA检查应用于OGIB具有较高诊断价值,且介入治疗采用栓塞术更能迅速止血,降低复发率,疗效切实,且安全可靠,值得临床深入研究。

Objective To explore clinic effect of applying digital subtraction angiography （DSA） and interventional therapy for obscure gastrointestinal bleeding （OGIB）. Methods 117 cases of patients with OGIB in our hospital were selected as research objectives and were divided into two groups according to interventional therapies. Observation group （72 cases） received endovascular embolization, while control group （45 cases） received drug perfusion treatment. Recorded the positive rate of DSA diagnosis. The clinical efficacy, adverse reaction and recurrence rate within 6 months were compared between the 2 groups. Results Bases on DSA examination result, among 117 cases,54 cases show direct sign, while 47 cases show indirect sign,the positive rate is 86.3% （ 101/117 ） according to diagnosis. The total effective rate of the observation group was 94. 4% ,which was significant higher than that of control group＇s 77.8% （ P 〈 0.01 ）. The adverse reaction rate of the observa- tion group was 13.9%, and that of the control group was 13.3%. There was no significant difference between the 2 groups （P 〉 0. 05 ）. Follow up for 6 month, The recurrence rate of observation group was 4.2%, which was significant lower than control team＇s 15.6% （P 〈0.05）. Conclusion DSA applied to OGIB has high diagnosis value and interventional therapy with embolization is more rapid hemostasis, reduce recurrence rate. The curative effect is remarkable, safe and reliable, so it is worthy of deeper clinical research.