消化道机械吻合术后吻合口出血的血管内栓塞治疗  

Endovascular Embolization for the Treatment of Anastomotic Bleeding After Stapled Digestive Tract Anastomosis

作　　者：李腾飞[1,2] 李臻[1,2] 任建庄[1,2] 张凯[1,2] 黄国灏 韩新巍[1,2] 焦德超[1,2] 

机构地区：[1]郑州大学第一附属医院放射介入科 [2]郑州大学介入治疗研究所,450052

出　　处：《临床放射学杂志》2014年第12期1918-1920,共3页Journal of Clinical Radiology

摘　　要：目的探讨血管内栓塞治疗消化道机械吻合术后吻合口出血的疗效和安全性。方法 28例经DSA检查证实消化道机械吻合术后吻合口出血患者,超选至病变责任供血动脉,采用血管内明胶海绵和/或弹簧圈栓塞治疗,观察其疗效并总结治疗经验。结果术中造影发现28例出血部位均位于机械吻合口处,并可见对比剂明显外溢,对其责任供血动脉进行超选并栓塞,术后患者腹腔留置引流管出血停止,实验室检查提示血红蛋白及红细胞计数未再下降。术中、术后均未出现与血管内治疗相关的并发症。结论急诊血管内栓塞治疗是消化道机械吻合术后吻合口出血安全、有效的治疗手段。Objective To evaluate the efficacy and safety of endovascular embolization in managing anastomotic bleeding after stapled digestive tract anastomosis. Methods A total of 28 patients with DSA-proved anastomotic bleeding after stapled digestive tract anastomosis were enrolled in this study. Super-selective catheterization of the responsible lesion-feeding artery was carried out, and the catheter was inserted into the responsible lesion-feeding artery, which was followed by endovascular embolization with Gelfoam and/or steel coils. The clinical effect was evaluated, and the experience was summarized. Results Intra-operative angiography showed that the bleeding artery was at the stapled anastomotic site in all 28 patients. Contrast extravasation was obviously seen. Super-selective embolization of the bleeding artery was performed. After the treatment, the abdominal indwelling drainage tube was placed and the bleeding ceased. Laboratory examination showed that hemoglobin level and red blood cell count did not decline again. No procedure-related complications occurred during and after the operation. Conclusion For the treatment of anastomotic bleeding after stapled digestive tract anastomosis, emergency endovascular embolization is safe and effective.

关 键 词：胃肠道机械吻合术 血管内治疗 吻合口出血 

分 类 号：R735[医药卫生—肿瘤]