数字减影血管造影在小肠出血诊断中的价值研究  

The Diagnostic Value of Digital Subtraction Angiography in Detecting Small Intestinal Bleeding

作　　者：李洪翠[1] 李肖[1] 李甫强[2] 唐承薇[1] 

机构地区：[1]四川大学华西医院消化内科,成都610041 [2]浙江大学第一医院胃肠外科,杭州310003

出　　处：《四川大学学报（医学版）》2011年第4期552-555,共4页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金项目(编号:30770984)资助

摘　　要：目的探讨数字减影血管造影(digital subtraction angiography,DSA)对小肠出血诊断的价值。方法对临床怀疑小肠出血的39例患者行DSA检查,对接受了外科手术治疗并取得手术及病理结果的患者评价DSA对小肠出血诊断的敏感性、特异性及准确性。对于大量出血、血流动力学不稳定者(收缩压<90 mmHg,休克指数>1)及不能耐受手术者同时履行介入栓塞止血。结果 39例患者中,DSA检查阳性者33例,8例成功实施介入栓塞止血。25例行外科手术,其中24例证实出血的部位及原因。DSA诊断小肠出血的敏感性为91.7%,特异性为100%,定位诊断准确度92%,与手术病理诊断的符合率为77.3%。结论 DSA是诊断小肠出血的有效方法,在明确诊断的基础上可同时实施介入治疗。Objective To determine the diagnostic value of digital subtraction angiography（DSA） in detecting small intestinal bleeding.Methods DSA was performed in 39 patients with suspected small intestinal bleeding.The sensitivity,specificity and accuracy of DSA were evaluated in the 25 patients who accepted surgical treatment.Results Among the 39 patients,33 came out with positive in DSA.Eight patients were given interventional embolization successfully.The sensitivity,specificity and accuracy of DSA in detecting small intestinal bleeding were 91.7%,100% and 92% respectively.The pathological results confirmed 77.3% of etiological diagnosis by DSA.Conclusion DSA is an effective method for detecting small intestinal hemorrhage.The accurate diagnosis can guide the intervention with embolization.

关 键 词：小肠出血 DSA 诊断 

分 类 号：R656.7[医药卫生—外科学]