肠系膜动脉造影联合美蓝注射对不明原因消化道出血的定位价值  

The value of combining mesenteric angiography with methylene blue injection for localization of the obscure gastrointestinal bleeding

作　　者：韩强[1,2] 张晓磷[1] 付志刚[2] 李海涛[1] 赵文江[2] 亓小虎[2] 

机构地区：[1]三峡大学第一临床医学院,湖北宜昌443003 [2]宜昌市中心人民医院放射科

出　　处：《实用放射学杂志》2015年第9期1515-1517,1530,共4页Journal of Practical Radiology

摘　　要：目的：探讨术前超选择性肠系膜动脉造影（SSMA）联合术中美蓝注射对不明原因消化道出血（OGIB）的定位价值。方法12例 OGIB 患者术前均行 SSMA,血管造影明确出血部位后将微导管保留于出血动脉分支内,继而在剖腹探查术中经微导管注射美蓝进行定位,切除被染色的肠管。结果12例患者术前 SSMA 出血部位检出率为100%。全部病变肠管均于手术中迅速被发现,切除肠管长度9～12 cm （平均10 cm）。术后随访10～24月（平均18月）,没有复发肠道出血。结论术前 SSMA 联合术中美蓝注射的方法,有助于明确 OGIB 部位,增加手术止血成功率,是一种安全、高效的 OGIB 定位方法。Objective To discuss the value of combining superselective mesenteric angiography （SSMA）with methylene blue injection for localization of the Obscure Gastrointestinal Bleeding （OGIB）.Methods 12 patients presenting with OGIB had preoperative localization of the bleeding site by SSMA.The microcatheter was remained inside the bleeding artery branch after angiography. Then the methylene blue was injected via the microcatheter for localization during exploratory laparotomy and the dyed intestine was then removed.Results The detected rate of bleeding sites by using preoperative SSMA was 100%.The lesions in total 12 patients were found quickly during the exploratory laparotomy.The length of the removed intestine was 9 -12 cm （median,10 cm）.After followed up for 10-24 months （median,18 months）,all patients with OGIB had no recurrence.Conclusion The method of SSMA combined with the use of methylene blue injection is a safe and effective procedure for the localization of OGIB and could be beneficial for increasing the surgical success rate of hemostasis.

关 键 词：消化道出血 超选择性 肠系膜动脉造影 美蓝 定位 

分 类 号：R572[医药卫生—消化系统] R814.43[医药卫生—内科学]