明胶海绵颗粒和弹簧圈用于下消化道出血介入治疗后肠黏膜表现

The manifestations of intestinal mucosa after interventional treatment of lower gastrointestinal hemorrhage with gelfoam particles and coils

目的探讨明胶海绵颗粒和弹簧圈用于下消化道出血的介入栓塞治疗后对肠黏膜的影响。方法采用回顾性研究方法,选取2011年12月至2019年12月于首都医科大学附属北京友谊医院行下消化道出血介入栓塞治疗的患者56例,术中采用弹簧圈为栓塞材料的29例患者归为弹簧圈组;采用明胶海绵颗粒为栓塞材料的27例患者归为明胶海绵颗粒组,收集其术后2~3周行肠镜检查的资料,对比观察两组患者的即时止血成功率和肠镜检查结果。结果明胶海绵颗粒组和弹簧圈组患者的即时止血成功率均为100%。明胶海绵颗粒组患者的内镜下肠缺血表现比率(51.85%)显著高于弹簧圈组(10.34%),差异具有统计学意义(P<0.0001)。结论下消化道出血的介入治疗中,在减少栓塞术后肠缺血并发症方面,弹簧圈优于明胶海绵颗粒,是一种安全有效的栓塞材料。

Objective To study the influence of the interventional treatment of lower gastrointestinal hemorrhage with gelfoam particles and coils on intestinal mucosa.Methods A retrospective study was performed on 56 patients,who underwent interventional embolization for lower gastrointestinal hemorrhage in Beijing Friendship Hospital,Capital Medical University during the period from December 2011 to December 2019.29 patients,during whose operation coils were used as embolization material,were classified into the coils group;27 patients,during whose operation gelfoam particles were used as embolization materials,were classified into the particles group.All patients underwent enteroscopy 2 to 3 weeks after the operration.The enteroscopy results were compared between the two groups.Results The immediate hemostasis rate of both groups was 100%.The proportion of intestinal ischemia in the gelfoam particles group(51.85%) was significantly higher than that in the coils group(10.34%) according to the endoscopic results,and the difference was statistically significant(P< 0.0001).Conclusion In the interventional treatment of lower gastrointestinal hemorrhage,embolization coil is better than gelfoam particle in reducing intestinal ischemia after embolization,and is a safe and effective embolization material.