α-氰基丙烯酸正丁酯栓塞治疗急性非肿瘤性小肠出血的安全性和疗效评价

The safety of α-N-butyl cyanoacrylate embolization in treating acute non-neoplastic small intestinal hemorrhage and evaluation of its therapeutic effect

目的评价α-氰基丙烯酸正丁酯(NBCA)经导管动脉栓塞治疗急性非肿瘤性小肠出血的安全性和有效性。方法回顾性分析2013年1月至2020年6月单中心采用NBCA胶经导管动脉栓塞治疗的15例急性非肿瘤性小肠出血患者临床资料和随访结果。其中男6例,女9例,年龄21~85岁。通过手术技术成功率、临床有效率、手术相关并发症和复发率评价NBCA胶栓塞治疗急性非肿瘤性小肠出血的安全有效性。结果15例患者中DSA造影表现为对比剂渗出8例,动静脉畸形3例,动脉瘤4例。所有患者均成功应用NBCA胶栓塞,技术成功率为100%。术后13例止血成功,临床有效率为86.7%。术后腹痛4例,未出现栓塞所致肠坏死需外科急诊处理。3例随访期出血复发,复发率为23.1%(3/13)。结论NBCA在急性非肿瘤性小肠出血栓塞治疗中有较高的安全有效性,更可靠的结论需要大样本随机对照研究证实。

Objective To evaluate the safety and efficacy of transcatheter arterial embolization(TAE)by usingα-N-butyl cyanoacrylate(NBCA)in treating acute non-neoplastic small intestinal hemorrhage.Methods The clinical data and follow-up outcomes of a total of 15 patients with acute non-neoplastic small intestinal hemorrhage,who were treated with TAE by using NBCA(NBCA-TAE)in a single medical center between January 2013 and June 2020,were retrospectively analyzed.The patients included 6 males and 9 females,aged(21-85)years.The technical success rate,clinical efficacy,procedure-related complications and recurrence rate were used to evaluate the safety and efficacy of NBCA-TAE in treating acute non-neoplastic small intestinal hemorrhage.Results Of the 15 patients,DSA demonstrated contrast media exudation in 8,arteriovenous malformation in 3,and aneurysm in 4.Successful NBCA-TAE was accomplished in all 15 patients,with a technical success rate of 100%.After NBCA-TAE,hemostasis was successfully achieved in13 patients,with a clinical success rate of 86.7%.Postoperative abdominal pain occurred in 4 patients,no intestinal necrosis caused by NBCA-TAE that needed to have emergency surgery treatment occurred.During follow-up period 3 patients developed recurrent bleeding,the recurrence rate was 23.1%(3/13).Conclusion In treating acute non-neoplastic small intestinal hemorrhage,NBCA-TAE is highly safe and effective,although larger sample randomized controlled studies need to be conducted before reliable conclusions can be definitely confirmed.