介入治疗在难治性消化道大出血中的临床研究(附51例报告)  

Clinical research of interventional therapy in incurable massive hemorrhage of digestive tract (Report of 51 cases)

作　　者：何明基[1] 申刚[1] 练辉[1] 王广宇[1] 李汉文[1] 陈德基[1] 

机构地区：[1]广州医学院第二附属医院放射科,广东广州510260

出　　处：《中国现代医学杂志》2008年第9期1270-1273,共4页China Journal of Modern Medicine

摘　　要：目的评价介入治疗在难治性消化道大出血(IMHDT)中的临床诊治价值。方法对51例IMHDT病人进行血管造影和选择性血管造影,并作经导管灌注止血药或行栓塞治疗。结果该组51例病人共作59次动脉造影,38例有异常表现,阳性率为74.5%;表现为造影剂外溢征(24例)、动脉瘤样改变(2例)、肿瘤(4例)、畸形血管团(2例)、血管痉挛样改变(1例)、炎症性改变(5例)。42例经介入治疗后出血停止,止血成功率为82.4%。9例经手术探查,7例手术病理证实符合血管造影定位诊断。无胃肠道坏死、穿孔等严重并发症发生。结论经导管动脉造影、栓塞治疗难治性消化道大出血,定位准确、安全有效,同时为外科手术争取了时间。[Objective] To evalute the value of clinical diagnosis and treatment with interventional therapy for the incurable massive hemorrhage in the digestive tract （IMHDT）. [Methods] 51 cases were performed with angiography and selective angiography （SAG）, They were treated using infusion with mdicine for arresting bleeding or embolizaton by the catheter. [Results] The group of arterial angiography had 38 abnormal cases. The positive rate was 74.5%. They presented as out flow of angiography agent （24 cases）, arterialangioma changes （2 cases）, tumor （4 cases）, malformation vascular mass （2 cases）, spasm changes （2 cases）, inflammation changes （5 cases）. 42 cases stopped bleeding after interventional therpay. The hemostasis rate was 82.4%. In 9 cases, surgical operation were performed for investigation. The results of operation and pathologic findings in 7 cases were proved that it conformed to the diagnosis of location by SAG. There were no serious complications. [ Conclusion] Angiography and arterial embolization for IMHDT is accurate of position and safe, effective. It could win some time for surgical operation to some patients.

关 键 词：难治性 消化道大出血 介入治疗 

分 类 号：R573.2[医药卫生—消化系统]