介入术中高压注射器压力对急性上消化道出血阳性检出的影响

Influence of High-Pressure Injection Pressure on Positive Detection of Acute Upper Gastrointestinal Hemorrhage During Interventional Surgery

目的探讨在急性上消化道出血血管造影中,提高微导管的高压注射压力对出血阳性检出率的影响。方法回顾性分析了2014年7月至2021年3月间因急性消化道出血于我院行急诊介入治疗的163例患者资料,结合其常规腹腔干、肠系膜上、肠系膜下、髂内动脉造影检查结果和术前资料判断有无可疑出血血管。其中113例发现可疑出血血管,需要进行微导管超选造影,在高压注射器的注射速率、注射总量条件相同的情况下按照高压注射器条件将其分为2组,51例患者在高压注射器200 psi的条件下、62例在400 psi条件下进行注射造影。分析不同注射压力对出血阳性检出率的影响。结果113例患者的微导管造影术中,200 psi条件下,51例患者共检出出血阳性35例;400 psi条件下,62例患者共检出出血阳性56例。两组患者在年龄、性别、体重、高血压情况、血红蛋白方面均无统计学差异(P>0.05),而400 psi的阳性检出率高于200 psi(90.32%vs.68.62%)。结论在急性上消化道出血的介入术中,提高微导管造影的高压注射压力对出血的阳性检出率有一定帮助。

Objective To investigate the effect of increasing the high-pressure injection pressure of the microcatheter on the positive detection rate of hemorrhage in angiography of acute upper gastrointestinal hemorrhage.Methods The data of 163 patients who received emergency interventional treatment for acute gastrointestinal bleeding in our hospital from July 2014 to March 2021 were retrospectively analyzed.Combined with preoperative data,the results of routine celiac trunk,superior mesentery,inferior mesenteric artery,internal iliac artery angiography were used to determine whether there were suspicious bleeding vessels.In 113 patients with suspicious bleeding vessels,microcatheter sonography was performed at the same flow rate and volume with a highpressure injection.According to the conditions of the high-pressure injector,they were divided into two groups,51 cases were injected at 200 psi and 62 cases were injected at 400 psi.The positive rate of bleeding with different injection pressures was analyzed retrospectively.Results Among 113 patients,35 patients(68.62%)were positive for hemorrhage at 200 psi,and 56 patients(90.32%)were positive for hemorrhage at 400 psi.The positive rate of 400 psi was higher than that of 200 psi.Furthermore,there was no statistical difference between the two groups in terms of age,gender,weight,hypertension and hemoglobin(P>0.05).Conclusion In the interventional operation of acute upper gastrointestinal bleeding,increasing the high-pressure injection pressure of microcatheter angiography is helpful to the positive detection rate of hemorrhage.