消化道动脉性大出血的DSA检查及其介入治疗  

DSA Inspection and Interventional Treatment of Massive Gastrointestinal Bleeding

作　　者：徐霖[1] 陈平友[1] 夏进东[1] 仇俊华[1] 周选民[1] 张海波[1] 王顺华[1] 

机构地区：[1]湖北省十堰市太和医院放射科,442000

出　　处：《中国医学影像学杂志》2002年第4期264-266,共3页Chinese Journal of Medical Imaging

摘　　要：目的 :探讨胃肠道动脉性大出血的DSA检查及介入栓塞治疗的价值。材料和方法 :18例胃肠道动脉性大出血经急诊DSA检查后 ,立即用丝线段、明胶海绵颗粒栓塞或局部药物灌注 ,术后常规保留导管 12～ 2 4小时。结果 :DSA发现动脉血管破裂出血 14例 ,另 4例仅见局部血管异常。栓塞后 12例出血立即停止 ;6例治疗后再出血 ,3例经再次栓塞后出血停止 ,3例作了外科手术治疗 ,无并发症发生。结论 :急诊DSA是确定胃肠道出血的一种准确方法 ,及时进行适当栓塞是控制出血的简便而有效的治疗手段 ,术中要注意保护功能动脉或终末动脉 ,术后应留管观察 ,以便造影复查和进一步治疗。Purpose: To explore the clinic value of DSA examine and interventional treatment in massive gastrointestinal bleeding. Materials and Methods: 18 cases of massive gastrointestinal bleeding were examined by emergency DSA. All cases were treated with tractheter arterial embolism (TAE) or tracatheter arterial infusion (TAI). Catheter were reserved generally for 12 24 hours after the treatment. Results: Rupture of artery vessel and bleeding was found in 14 cases, the local abnormal blood vessel were found in 4 cases. The bleeding was ceased immediately after TAE in 12 cases. The bleeding again within 12 hours was seen in 6 cases and embolized again by TAE in 3/6 cases, The other 3 cases were undertaken surgery treatment. There was no complication in all patients. Conclusion: Emergency DSA is an effective diagnostic method of choice for managing massive gastrointestinal bleeding. It is a simple and reliable rnethod for control of bleding following embolization. Protecting the functional artery or end branch should be noticed during the treatment and catheter should be reserved in order to inspect again or advance therapy after initial TAE.

关 键 词：消化道动脉性大出血 介入治疗 胃肠出血 栓塞 血管造影 

分 类 号：R573.2[医药卫生—消化系统] R816.5[医药卫生—内科学]