单纯明胶海绵在难治性上消化道出血栓塞治疗中的临床应用

目的评价明胶海绵作为栓塞剂在动脉内栓塞治疗难治性上消化道出血的安全性和有效性。方法对18例消化道出血患者采用股动脉穿刺插管，选择胃十二指肠动脉、胃左动脉、肠系膜上动脉、腹腔干动脉行数字减影血管造影（DSA）检查。并酌情对脾动脉、肝固有动脉行超选DSA，发现出血动脉及其他异常动脉显影，用高压消毒过的明胶海绵颗粒和新鲜明胶海绵条栓塞靶血管。结果18例患者DSA首次血管造影阳性者16例。在16例DSA阳性的消化道出血患者中进行栓塞治疗，止血成功15例，有效止血率为93．75％（15／16例）。对2例DSA结果阴性的消化道出血病例进行试验性栓塞，止血成功1例，有效止血率为50％（1／2例）。结论采用明胶海绵作为栓塞剂在动脉内栓塞治疗难治性上消化道出血是一种经济、安全、有效的方法。

Simple gelfoam embolization in refractory upper gastrointestinal bleeding in clinical application

Objective To evaluate the gelatin sponge as embolic agents artery embolization in the safety and efficacy of refractory upper gastrointestinal bleeding. Methods 18 cases of alimentary tract hemorrhage patients with femoral artery puncture intubation, selective gastroduodenal artery, left gastric artery, superior mesenteric artery, celiac axis line of digital subtraction angiography （DSA） inspection. And, as appropriate, splenic artery, proper hepatic artery DSA, found bleeding and other abnormal artery imaging, with high-pressure sterilized article gelatin sponge particles and fresh gelatin sponge embolism target blood vessels. Results 18 patients DSA angiography was 16 cases for the first time. Positive in 16 cases DSA embolization therapy in patients with alimentary tract hemorrhage, bleeding 15 cases were successful, effective hemostatic rate was 93.75% （15/16）. Negative results of 2 cases of DSA experimental thrombosis of all mentary tract hemorrhage cases, the bleeding success in 1. Effective hemostatic rate was 50%（1/2）. Conclusion With gelatin sponge as embolism agent artery embolization in intractable upper gastrointestinal bleeding is a safe, effective and economic method.