数字减影血管造影诊断及介入治疗不明原因下消化道出血  

Digital subtraction angiographic diagnosis and interventional treatment for lower digestive tract hemorrhage of unknown cause

作　　者：姚宜斌[1] 金玲[1] 胡章明[1] 林天增[1] 

机构地区：[1]安徽省铜陵市人民医院放射科,244000

出　　处：《蚌埠医学院学报》2007年第6期737-738,741,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨不明原因下消化道出血数字减影血管造影(DSA)检查和介入治疗的方法及临床应用价值。方法:不明原因消化道出血38例行DSA检查。通过显示造影剂外溢、病理血管和肿瘤染色确定出血原因及部位,对出血处行超选择动脉插管灌注血管加压素止血或明胶海绵、含钡聚乙烯(PVA)微球栓塞治疗。结果:血管造影阳性27例,其中血管畸形17例,肿瘤6例,小肠憩室3例,回盲部溃疡1例。介入治疗27例,其中17例血管加压素灌注止血,即时止血13例,止血率76%;10例介入栓塞治疗,即刻止血8例,2例术后24 h出血停止。结论:DSA检查和介入治疗对不明原因下消化道出血有重要的诊断及治疗价值。Objective:To investigate the clinical value of digital subtraction angiography(DSA) diagnosis and interventional therapy for lower digestive tract hemorrhage of unknown cause.Methods:DSA was performed in 38 patients with lower digestive tract hemorrhage of unknown cause.The locations and causes of hemorrhage were determined by angiography according to the demonstration of contrast medium extravasation,abnormal vasculature and tumor staining.Infusion of vasopressin or embolization with spongia gelatinosa absorbentia and polyvinyl alcohol(PVA) were used after superselective catheter had been inserted in the bleeding artery.Results:Twenty-seven patients were positive in angiogram,17 patients of lower digestive tract hemorrhage caused by arterial venous malformation,6 by tumor,3 by intestinal diverticulm and 1 by caecum ulcer.Twenty-seven patients had been given the interventional therapy.In 17 of 27 patients that had been treated with infusion of vasopressin,13 patients stopped bleeding immediately(76%).In 10 patients with embolization,8 patients stopped bleeding immediately and 2 patients stopped bleeding after 24 hours.Conclusions:DSA and interventional therapy have important value in diagnosis and treatment of patients with lower digestive tract hemorrhage of unknown cause.

关 键 词：出血 肠疾病 数字减影血管造影 介入治疗 栓塞 治疗性 

分 类 号：R442.7[医药卫生—诊断学] R574[医药卫生—临床医学]