急性动脉性内脏出血的选择性动脉造影和栓塞治疗

目的：探讨经导管选择性动脉内造影及栓塞对急性动脉性内脏出血的诊断和治疗价值，评价其临床疗效及安全性。材料和方法：选择36例急性出血患者进行选择性动脉造影和选择性栓塞术，其中支气管扩张症所致大咯血16例，肺癌所致大咯血2例，胃或十二指肠溃疡所致呕血4例，不明原因小肠出血所致便血2例，不明原因大肠出血所致便血4例，经皮胆道引流术后胆道出血所致便血1例，外伤或肾活检所致肾周血肿6例，肾动静脉瘘所致血尿1例。结果：诊断不明确的患者经动脉造影均获得明确诊断，经选择性栓塞治疗35例出血得到控制，仅1例结肠出血患者未能止血。栓塞术后1例肺癌患者出现截瘫，1例小肠出血患者栓塞后出现小肠坏死，行肠切除肠吻合术后痊愈，其余患者均未出现与介入治疗相关的并发症。结论：介入性动脉造影及栓塞治疗急性内脏动脉性出血是一种安全、有效的诊断和治疗方法。

Selective angiogram and embolization via catheters for acute splanchnic arterial bleeding

Objective:To explore the diagnostic and therapeutic value of selective angiogram and embolization via catheters for acute splanchnic arterial bleeding.Methods:Selective angiogram and embolization via catheters were performed in 36 cases of acute splanchnic arterial bleeding including 16 cases of hemoptysis caused by bronchiectasis,2 cases of hemoptysis caused by lung cancer,4 cases of haematemesis caused by gastric or duodenal ulcer,2 cases of alvine blood and 4 cases of colonic blood for unknown factor,one case of bile blood caused by PTCD procedure,6 cases of renal hematoma caused by trauma or biopsy,hematuria caused by renal arteriovenous malformation.Results:Causes of bleeding in all patients were ascertained through angiogram and 35 of 36 cases were stanched with embolization.One case of colonic blood was not stanched because of incomplete embolization.Paraplegia appeared in one case of lung cancer after embolization of bronchial arteries.Intestinal putrescence arised in one case of alvine blood after embolization who underwent operation and recovered.Conclusion:Selective angiogram and embolization via catheters is safe and effective for acute splanchnic arterial bleeding.