同轴微导管PVA栓塞介入治疗动脉性下消化道出血的研究  

Study of coaxial microcatheter PVA embolization in the treatment of arterial lower gastrointestinal hemorrhage

作　　者：孙泽西 王洋 赵菲 SUN Zexi;WANG Yang;ZHAO Fei(Interventional Operation Room,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院介入手术室,河南洛阳471000

出　　处：《广州医药》2024年第8期869-874,共6页Guangzhou Medical Journal

基　　金：河南省医学科技攻关项目(LHGJ202101236)。

摘　　要：目的研究同轴微导管聚乙烯醇颗粒(PVA)栓塞治疗动脉性下消化道出血患者的应用效果。方法本研究为前瞻性研究,选择河南科技大学第一附属医院2022年1月—2023年6月收治的118例动脉性下消化道出血患者为研究对象,以计算机随机分组法将其分为常规组和试验组,各59例。两组均行数字减影血管造影检查明确出血情况,常规组予以内镜下注射止血治疗,试验组经同轴微导管PVA栓塞进行止血治疗,比较两组患者的治疗效果及预后情况。结果在不同治疗方案下,试验组的技术成功率、临床成功率分别为89.83%(53/59)、84.75%(50/59),均高于常规组[71.19%(42/59)、64.41%(38/59)](χ^(2)=11.071、10.911,P<0.05);试验组的止血时间、凝血酶原时间(PT)、凝血酶时间(TT)分别为(50.25±10.37)min、(10.25±2.31)s、(16.33±4.47)s,均低于常规组[(55.36±10.72)min、(12.44±3.61)s、(19.35±4.23)s](t=2.632、3.925、3.769,P<0.05);试验组治疗后的动脉搏动指数(PI)、阻力指数(RI)分别为(1.12±0.33)(0.51±0.21),均低于常规组[(1.65±0.41)(0.73±0.22)](t=7.735、5.556,P<0.05);试验组治疗7、14、30 d后的再出血率分别为5.08%(3/59)、8.47%(5/59)、10.17%(6/59),均低于常规组[20.34%(12/59)、25.42%(15/59)、28.81%(17/59)](χ^(2)=10.495、10.207、11.071,P<0.05);试验组的并发症发生率8.47%(5/59)低于常规组22.03%(13/59),差异均具有统计学意义(χ^(2)=7.113,P<0.05)。结论与常规内镜下止血相比,同轴微导管PVA栓塞可显著提升动脉性下消化道出血患者的止血成功率,对缩短患者止血时间、促进凝血系统恢复、降低再出血风险及相关并发症发生风险均有积极意义。Objective To study the effect of coaxial microcatheter PVA embolization in the treatment of patients with arterial lower gastrointestinal bleeding.Methods This study is a prospective study,118 patients with arterial lower gastrointestinal bleeding admitted between January 2022 and June 2023 were selected as the study subjects.They were randomly divided into a conventional group(59 cases)and an experimental group(59 cases)using computer randomization.Both groups underwent digital subtraction angiography examination to determine the bleeding situation.The conventional group received conventional endoscopic hemostasis treatment,while the experimental group received coaxial microcatheter PVA embolization for hemostasis treatment.The treatment efficacy and prognosis were compared between two groups.Results Under different treatment plans,the technical success rate and clinical success rate of the experimental group were 89.83%(53/59)and 84.75%(50/59),respectively,which were higher than those of the conventional group[71.19%(42/59)and 64.41%(38/59)](χ^(2)=11.071、10.911,P<0.05).The hemostatic time,PT,and TT of the experimental group were(50.25±10.37)min,(10.25±2.31)seconds,and(16.33±4.47)seconds,respectively,which were shorter than those of the conventional group[(55.36±10.72)min,(12.44±3.61)seconds,and(19.35±4.23)seconds](t=2.632、3.925、3.769,P<0.05).The arterial PI and RI of the experimental group after treatment were(1.12±0.33)and(0.51±0.21),lower than those of the conventional group[(1.65±0.41)and(0.73±0.22)](t=7.735、5.556,P<0.05).The rebleeding rates of the experimental group after 7 days,14 days and 30 days of treatment were 5.08%(3/59),8.47%(5/59)and 10.17%(6/59),respectively,which were lower than those of the conventional group[20.34%(12/59),25.42%(15/59)and 28.81%(17/59)](χ^(2)=10.495,10.207,11.071,P<0.05).The incidence of complications in the experimental group was 8.47%(5/59),which was lower than that in the conventional group 22.03%(13/59)(χ^(2)=7.113,P<0.05).Conclusions Compared with con

关 键 词：动脉性下消化道出血 同轴微导管 聚乙烯醇颗粒 介入栓塞 止血效果 

分 类 号：R57[医药卫生—消化系统]