不明原因消化大出血的造影诊断及介入治疗  

The diagnosis and intervention therapy of massive hemorrhage with unknown reason in gastrointestinal tract

作　　者：袁海[1] 

机构地区：[1]蚌埠市第三人民医院放射科,蚌埠233000

出　　处：《安徽卫生职业技术学院学报》2006年第5期21-22,共2页Journal of Anhui Health Vocational & Technical College

摘　　要：目的:评价选择性动脉造影和动脉栓塞在不明原因的消化道大出血的诊断治疗中应用。方法:对我院收治的5例消化道大出血的病人行DSA造影,并行动脉栓塞或药物灌注止血治疗。使用5Fcobra导管和3Fsp微导管,选择性插管至腹腔干或肠系膜上、下动脉造影,并对明确出血血管行超选择插管至出血动脉行动脉栓塞止血治疗。结果:DSA示:3例造影未见明显的异常血管,仅给予缩血管药物灌注止血。2例有明确的出血征象,其中1例十二指肠降部动脉畸形,1例肠系膜上动脉的回结肠动脉末梢破裂出血,用微导管插至出血动脉末级分支行明胶海绵及真丝线段颗粒栓塞治疗,均达到止血作用。结论:选择性动脉造影对不明原因的消化道大出血具有一定的诊断价值,通过选择性插管行DSA并对异常血管或出血血管栓塞和药物灌注可以起到诊断与治疗作用。Objective To evaluate the application of selective artery angiography and embolization in the diagnosis and therapy of unknown reason of massive hemorrhage of gastrointestinal tract. Methods DSA was performed in 5 cases with massive hemorrhage of gastrointestinal tract in our hospital, and selective artery embolization or perfusion was used to control bleeding. The celiac artery, super mesenteric artery and inferior mesenteric artery angiography were performed selectively and respectively with 5 F cobra catheter and 3 Fsp microcatheter. The obvious bleeding vessels were embolized when super selective catheterization were achieved in order to control the bleeding. Results There were no obvious abnomal vessels, demonstrated in DSA in 3 cases and vaso-excitor materials were perfused through catheter. 2 cases with obvious bleeding sign were embolized witla gettoam or silk particle when microcatheter reached to the site of bleeding. Among them, one was artery malformation located in descendent duodenum, another was rupture of periphery artery arising from ileocolic artery which originated from SMA. Conclusion Selective angiography with DSA is useful in the diagnosis of unknown cause GIB, and at the same time embolization and perfusion through selective catheterization can be applied for abnomal or rupture vessels.

关 键 词：介入治疗 消化道大出血 栓塞 止血 

分 类 号：R573.2[医药卫生—消化系统]