山莨菪碱在腹部脏器出血DSA术中的应用

目的:探讨山莨菪碱在腹部脏器出血数字减影血管造影(digital subtraction angiography,DSA)术中的应用价值.方法:33例接受腹部急诊DSA的消化系出血和肾脏出血患者,其中男20例,女13例,年龄19-89岁,平均57岁.造影前于肠系膜上动脉灌注盐酸山莨菪碱10mg.选择性腹部动脉造影后观察出血病变的显示情况和肠蠕动等伪影抑制效果,同时结合非屏气摄影方法进行蒙片重设改善减影配对不良.发现出血部位后,对供血动脉分支行超选择栓塞治疗.结果:所有患者动脉内注入山莨菪碱后行血管造影,均能有效抑制胃肠蠕动形成的移动伪影.除口干之外未见不良反应.运用重选蒙片方法进一步消除了呼吸运动对图像质量的影响,获得了满足临床诊断的清晰图像.27例(81.82%)发现出血征象并成功栓塞了病变供血动脉.结论:在腹部脏器出血的DSA术中,动脉灌注山莨菪碱并结合非屏气摄影技术,能很好抑制和排除胃肠蠕动及呼吸运动造成的伪影,安全、简便,是提高图像质量的有效方法.

Application of anisodamine to emergency digital subtraction angiography for abdominal organ hemorrhage

AIM:To explore the value of anisodamine applied to emergency digital subtraction angiography (DSA) for abdominal organ hemorrhage.METHODS:Thirty-three patients with gastrointestinal or kidney hemorrhage underwent emergency DSA.Arterial injection of 10 mg of anisodamine was employed before angiography.DSA images were acquired during free breathing and post-processed using re-mask function.RESULTS:Artifacts caused by gastrointestinal peristalsis were reduced remarkably.The image quality was satisfactory in all cases.Bleeding signs were presented in 27 cases (81.82%) and endovascular embolization was performed after superselective catheterization of the lesioned vessels.CONCLUSION:The use of anisodamine before angiography can improve the quality of images acquired by emergency DSA for abdominal organ hemorrhage.