CO_2-DSA在小肠出血诊断中的价值  

The value of CO_2-DSA in the diagnosis of small intestinal bleeding

作　　者：卢伟[1] 杨超[1] 张嘉诚[1] 杨剑[1] 杜鹏[1] 马军朋[1] 张哲[1] 蒋富强[1] LU Wei ,YANG Chao, ZHANG Jiacheng ,YANG Jian ,DU Peng, MA Junpeng ,ZHANG Zhe ,JIANG Fuqiang(Department of Interventional Medicine, Navy General Hospital of People＇s Liberation Army, Beijing 100048, Chin)

机构地区：[1]中国人民解放军海军总医院介入医学科,北京100048

出　　处：《中国医药导报》2018年第10期118-121,共4页China Medical Herald

基　　金：北京市民健康培育项目(Z151100003915112)

摘　　要：目的比较CO_2-DSA和非离子碘造影剂在诊断小肠出血中的作用。方法选择2015年10月~2017年6月在中国人民解放军海军总医院确诊为小肠出血患者20例分别用CO_2和碘造影剂行肠系膜上、肠系膜下动脉造影,并超选择到疑似出血部位的肠系膜上、下动脉3级分支重复造影,采用盲法评价两种造影剂显示消化道出血的阳性率。结果在肠系膜上、下动脉主干造影时,CO_2显示7例(7/20),碘造影剂显示9例(9/20),两组比较差异无统计学意义(χ~2=0.417,P>0.05)。在超选择到肠系膜动脉3级分支造影时,CO_2-DSA显示20例消化道出血中的19例(95.0%),碘造影剂-DSA显示14例(70.0%),差异有统计学意义(χ~2=4.329,P<0.05)。结论在超选择到接近出血靶动脉造影时,CO_2气体在显示小肠出血比常规碘造影剂更具优势。Objective To compare the role of CO_2-DSA and non-ionic iodine contrast agent in diagnosis of intestinal bleeding. Methods 20 cases of patients with small intestinal bleeding treated in Navy General Hospital of People′ s Liberation Army from October 2015 to June 2017 were selected. Superior and inferior mesenteric arteries angiography were performed in 20 patients by use of both CO_2 and iodinated contrast agent. Repeated angiography was performed with super-selective catheterization of the third level branches of suspected arteries. The images were evaluated blindly. The positive depicted of bleeding in both CO_2 and iodine contrast agents were compared. Results Small intestinal bleeding was demonstrated in 7 cases（7/20） with CO_2-DSA, while 9 cases with iodine contrast agent-DSA（9/20）, there was no significant difference between the two groups（χ~2=0.417, P〈0.05）. Small intestinal bleeding was showed in 19 of the 20 cases by CO_2-DSA（95.0%）, while 14 cases（70.0%） by iodine contrast agents, with statistically significant difference（χ~2=4.329, P〈0.05）. Conclusion CO_2 gas is superior to iodine contrast agent in demonstrating small intestinal bleeding in case of super-selective catheterization near the bleeding arteries.

关 键 词：消化道出血 血管造影 二氧化碳 碘造影剂 

分 类 号：R445.3[医药卫生—影像医学与核医学]