数字减影血管造影对不明原因消化道出血的诊断和治疗价值  

Diagnostic and Therapeutic Value of Digital Subtraction Angiography in Obscure Gastrointestinal Bleeding

作　　者：王剑[1] 程洁敏[2] 凌跃新[3] 

机构地区：[1]复旦大学附属中山医院消化科,上海200032 [2]复旦大学附属中山医院介入科,上海200032 [3]复旦大学附属中山医院普外科,上海200032

出　　处：《中国临床医学》2012年第3期252-254,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨数字减影血管造影(digital subtraction angiography,DSA)对不明原因消化道出血病例的诊断和治疗价值。方法:回顾性分析67例因不明原因的消化道出血行DSA的患者的临床资料。DSA采用Seldinger技术,行肠系膜下动脉、肠系膜上动脉、腹腔动脉造影,分析造影征象以对出血部位和病因作出诊断。根据不同出血原因采用栓塞、药物收缩血管等方法进行介入治疗,并对外科手术治疗的病例采用导丝或导管进行术前定位。结果:DSA检测出血病灶的阳性率为43.3%,其中小肠出血占37.9%,结肠出血占62.1%。手术和造影证实,肿瘤性出血8例(27.6%),非肿瘤出血21例(72.4%),两者差异有统计学意义(P<0.01)。结论:DSA对不明原因消化道出血有较好的诊断和治疗价值;并且在造影中发现出血部位后置入标记物,可以为手术中寻找病变部位提供很有效的定位标记。Objective：To evaluate the value of digital subtraction angiography（DSA） in obscure gastrointestinal bleeding （OGB）. Methods.. A total of 67 cases of OGB undergoing DSA of the celiac, superior mesenteric and inferior mesenteric arteries have been enrolled in this study. Therapies for them included interventional radiology and surgery. Embolization and vasopressin infusion were applied according to the different causes of bleeding. For those patients who underwent surgery, guide wire or catheter was placed as a marker for intra-operative localization. Results.. DSA showed 43.3% of OGB, among them 37.9% of the hemorrhage lesions were in small intestinal and 62. 1% were in colon, twenty-seven cases （72. 4%） of OGB were no, tumorous and 8 cases（27. 6%） were tumorous. Conclusion： DSA was of great value in the diagnosis and treatment of OGB.

关 键 词：消化道出血 血管造影 介入治疗 定位方法 

分 类 号：R573[医药卫生—消化系统]