介入诊断和治疗在消化道出血中的临床应用

目的 评价介入方法在消化道出血诊断和治疗中的应用价值。方法 急、慢性消化道出血患者32例，其中肿瘤性病变12例，血管源性病变20例。32例行DSA检查，27例行CT血管造影(CTA)和钡剂检查，其中13例同时行DSA，CTA和钡剂检查。共对10例血管源性病变患者行介入栓塞治疗。结果 32例消化道出血病变在DSA检查中均清晰显示。DSA检查特别适用于肠道血管异常病变，结合CTA有利于提高肠道黏膜下病变诊断。10例介入栓塞止血均100％成功，术后随访6个月～2年，无并发症及复发。结论 超选择性DSA检查和CTA在消化道出血诊断中具有较高应用价值，对于消化道出血性病变，介入栓塞是一种有效、微创的治疗方法。

Clinical application of interventional diagnosis and therapy in gastrointestinal hemorrhage

Objective To evaluate the effect of interventional diagnosis and therapy in gastrointestinal hemorrhage. Methods 32 patients with gastrointestinal hemmorrhage, including 12 cases of tumor and 20 cases of vascular malformation were analized retrospectively. DSA was performed in 32 cases, barium meal radiography were undertaken in 27 cases. DSA, CTA and barium meal radiography were all performed in 13 cases. Superselective embolization was performed in 10 cases with vascular malformation. Results DSA showed clearly the radiologic features all gastrointestinal hemorrhage. Coupled DSA with CTA was reliable for diagnosis of intestinal submucosa tumor. All five cases of vascular malformation underwent successful superselective embolization showing no complication and relapse during 6 month to 2 years. Conclusions Superselective DSA and CTA are valuable methods for the diagnosis of gastrointestinal hemorrhage. Interventional embolization is an effective modarity in the treatment of gastrointestinal hemorrhage.