十二指肠溃疡并出血精细栓塞的疗效分析

Curative Effect Analysis of Fine Embolization of Duodenal Ulcer Complicated with Hemorrhage

目的:总结十二指肠溃疡并大出血行动脉精细栓塞止血的临床经验。方法:对2014年1月至2016年12月期间36例十二指肠溃疡并大出血患者行介入栓塞止血的病例资料进行回顾性分析。结果:36例患者中有效止血31例,无效止血5例,介入栓塞止血成功率85.7%。术后出现的并发症有肠管坏死(2例),股动脉穿刺点血肿(1例)。结论:对十二指肠溃疡并出血的患者行精细栓塞止血是可行的,术前予以积极准备,栓塞前需评估血管侧支吻合情况,栓塞程度及范围、栓塞剂种类及颗粒大小等情况,以提高介入栓塞成功率、减少并发症。

Objective:To summarize the clinical experience of gastroduodenal artery embolization for the treatment of duodenal ulcer and massive hemorrhage.Methods:Retrospective analysis was performed on 36 patients with duodenal ulcer and massive bleeding who underwent embolization and hemostasis between January 2014 and December 2016.Results:Among 36 patients, 31 were effective hemostasis and 5 were ineffective., and the overall success rate of interventional embolization was 85.7%. The postoperative complications of necrosis of the bowel necessitated surgical intervention(2 cases) and femoral artery puncture hematoma(1 case).Conclusion:It is feasible to perform embolization and hemostasis in patients with duodenal ulcer and massive hemorrhage. Prepare actively before operation, assess the side branch anastomosis of the vessel before embolization, the extent and scope of embolism, type of embolic agent and particle size has an effect on embolization,and the success rate of interventional embolization should be increased as much as possible to reduce complications.