数字减影血管造影下预置造影导管在急性下消化道大出血手术治疗中的应用  

Application of preimplanted angiography catheter with digital subtraction angiography for surgical treatment of acute lower gastrointestinal bleeding

作　　者：李艳奎[1] 陈剑秋[1] 李学东[1] 陈博[1] 金红梅[1] 吴义生[1] 

机构地区：[1]天津医科大学第二医院血管外科,300211

出　　处：《中华全科医师杂志》2015年第7期555-557,共3页Chinese Journal of General Practitioners

摘　　要：为探讨数字减影血管造影（DSA）下预置造影导管在急性下消化道大出血手术中的可行性及意义，回顾性分析2011年6月至2014年12月序贯治疗的17例急性下消化道大出血患者的临床资料。所有患者均在DSA下预置造影导管和寻找出血病灶，同时联合行外科手术。结果显示，17例患者根据造影导管引导注入亚甲蓝后全部顺利查明出血病灶并行手术治疗，其中，出血病灶位于小肠8例、大肠9例。术后病理学检查示，肠道动脉血管畸形4例（其中小肠血管畸形2例，结肠血管畸形2例），溃疡性结肠炎3例，结肠癌1例，结肠憩室3例，小肠间质瘤6例。提示对于急性下消化道大出血患者，经积极非手术治疗无效时，采用DSA下预置造影导管联合手术治疗，有利于术中查找出血病灶、彻底手术切除病灶，是一种安全、有效的治疗方法。To evaluate the application of preimplanted angiography catheter with digital subtraction angiograply（DSA） for surgical treatment of acute lower gastrointestinal bleeding. Clinical data of 17 patients with acute lower gastrointestinal bleeding admitted from June 2011 to December 2014 were retrospectively reviewed. The angiography catheter was implanted and methylene was injected to find the bleeding sites with DSA, then emergency laparotomy was performed. The results showed the bleeding sites in small intestine in 8 cases and in large intestine in 9 cases. Postoperative pathology revealed vascular malformation in 4 cases, 2 in small intestine and 2 in colon ; ulcerative colitis in 3 cases; colon cancer in 1 case; colonic diverticula in 3 cases and small intestinal stromal tumor in 6 cases. Results indicate that if the conservative therapy is not effective, surgical treatment assisted by preimplanted angiography catheter with DSA is safe and effective for oatients with lower ~astrointestinal bleeding.

关 键 词：血管造影术 数字减影 胃肠出血 

分 类 号：R656[医药卫生—外科学]