动脉内栓塞治疗造影阴性的急性上消化道出血  

Arterial embolization for acute upper gastrointestinal tract bleeding with negative catheter angiography

作　　者：张树柳 柳玉刚[2] 张丽丽[1] 张国栋[3] ZHANG Shuliu1 , LIU Yugang2, ZHANG Lili1 , ZHANG Guodong3(1. Department of Intensive Care Unit, Chinese PLA Jinan Military Command General Hospital, Jinan 250013, P. R. China ;2. Emergency Center of Haiyang City People＇s Hospital, Haiyang 265100, P. R. China; 3. Shandong Medical hnaging Researeh Institute Affiliated to Shandong University, Jinan 250021, P. R. China)

机构地区：[1]中国人民解放军济南军区总医院重症医学科,山东济南250013 [2]山东省海阳市人民医院急诊科,山东海阳265100 [3]山东大学附属山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2018年第9期1489-1492,共4页Journal of Medical Imaging

摘　　要：目的探讨经导管动脉内栓塞治疗动脉造影阴性的上消化道出血的可行性与有效性。方法回顾性分析自2016年7月～2017年12月,在我科接受经动脉内栓塞治疗上消化道出血患者中,有13例为动脉造影阴性的。对于出血动脉的判定依靠血管的截断、异常狭窄或增粗、假性动脉瘤形成、异常血管增生的造影征象,并结合消化道内镜提供的信息。栓塞材料为明胶海绵颗粒联合微弹簧圈。结果技术成功栓塞12例(92. 3%,12/13),技术失败1例(7. 7%,1/13);栓塞后1周的临床有效率为10/12(83. 3%),无严重并发症发生。结论动脉内栓塞治疗动脉造影阴性的上消化道出血是可行与有效的。Objective To evaluate the feasibility and efficiency of arterial embolization for acute massive gastrointestinal bleeding with negative catheter angiography. Methods From July 2016 to December 2017, 13 patients suffering from acute gastrointestinal bleeding underwent arterial embolization with negative catheter angiography at our interventional department. The target bleeding vessel for embolization was based on vessel cut off, vessel irregularity （ stenosis or enlargement） , aneurysms/pseudoaneurysms, and hypervascularity as seen in angiodysplasia, and the additional information provided by endoscopy. The embolie agents were gelfoam particles combined with mieroeoils. Results Technical success was achieved in twelve of 13 patients （92. 3%, 12/13） and technical failure was achieved in 1 patient （7.7%, 1/13）, and clinical success in the 12 patients was 10/ 12（83.3% ） at 1 week follw-up postembolization. No major complications were encountered. Conclusion Arterial embolization is a feasible and efficacious alternative for massive gastrointestinal bleeding with negative catheter angiography.

关 键 词：上消化道出血 血管造影术 栓塞治疗 介入性 放射学 

分 类 号：R573.2[医药卫生—消化系统] R815[医药卫生—内科学]