血管造影及栓塞技术在Dieulafoy病诊治中的价值  

Angiographic diagnosis and therapeutic embolization of Dieulafoy disease

作　　者：高天俊[1] 吴东海[1] 张宏光[1] 徐志勇[1] 刘利兰[1] 范义[1] 娄明武[1] 

机构地区：[1]深圳市龙岗中心医院介入放射科,518116

出　　处：《中华放射学杂志》2015年第2期130-132,共3页Chinese Journal of Radiology

摘　　要：目的：探讨血管造影及栓塞技术在Dieulafoy病诊治中的作用。方法回顾性分析经内镜检查诊断为Dieulafoy病或已排除消化性溃疡、门静脉高压症等病因的消化道大出血患者17例。患者均行DSA血管造影及介入栓塞治疗。术后观察患者栓塞止血效果和不良反应。随访患者1年，观察是否出现再次出血。结果17例中，16例血管造影均符合Dieulafoy病改变。对16例造影异常患者均行明胶海绵颗粒栓塞，15例栓塞治疗后均出血停止、血压回升，治疗成功。1例栓塞术后3 d再次呕血，于外科行胃大部切除术。9例于术后2～4d出现不同程度的左上腹及剑突下疼痛、烧灼样不适，予抑酸等对症治疗后缓解。15例栓塞治疗者均无胃肠坏死等严重并发症发生。对15例治疗成功者随访1年，均无再次呕血、黑便等症状。结论血管造影及栓塞技术诊治Dieulafoy病安全、有效。Objective To evaluate the clinical efficacy of interventional techniques in the diagnosis and therapy of Dieulafoy disease. Methods A retrospective study was performed, including 17 patients with massive upper gastrointestinal hemorrhage （patients without peptic ulcer and portal hypertension or diagnosed with Dieulafoy disease by endoscopic examination）. All patients had both DSA and interventional embolization treatment, and were followed for 12 months to appraise the clinical effectiveness. Results Sixteen patients were diagnosed as Dieulafoy disease by using DSA. Fifteen of the 16 patients were treated with embolization successfully withoutserious complications. One patient received subtotal gastrectomy because of upper gastrointestinal hemorrhage recurrence. Nine patients with irregular upper abdominal pain and burning sensation had complete remission after symptomatic management. Fifteen patients who had embolization showed no serious complications during the follow-up period of 12 months, there was no hematemesis and melena for the 15 cases with successful embolization. Conclusion The angiography and embolization are safe and efficacious in the diagnosis and therapy of Dieulafoy disease.

关 键 词：DIEULAFOY病 胃肠出血 栓塞 治疗性 

分 类 号：R57[医药卫生—消化系统]