消化道出血的血管造影诊断与介入治疗

目的：探讨介入诊断和治疗对急性消化道出血的应用及其价值。方法：急性消化道出血病例23例，常规在腹腔动脉和肠系膜上、下动脉插管造影。造影后保留导管持续灌注血管加压素或行栓塞治疗，追踪观察止血情况。结果：23例中14例有血管异常表现，其中5例见造影剂外溢。17例行灌注治疗，6例行栓塞治疗。22例在介入治疗后止血，I例治疗无效死于多脏器功能衰竭。结论：诊断不明确或经保守治疗无效的消化道出血患者数字减影血管造影(DSA)检查及介入治疗有重要的临床价值。

Angiographic diagnosis and transcatheter therapy for gastrointestinal hemorrhage

Objective: To evaluate the clinical value of angiographic diagnosis and effectiveness of transcatheter therapy in gastrointestinal arterial hemorrhage. Methods:DSA of celiac, superior mesenteric and inferior mesentic arteries were performed in 23 patients with gastrointestinal hemorrhage. According to the revealed causes and positions of bleeding during angiography, intraarterial vasopressin infusion or embolus therapy was used in the bleeding branch artery. Results:60.87% of these patients were identified by angiography. 17 cases treated with vasopressin infusion were effective,one case died of multi organ function failure,six cases treated by embolus therapy were all successful with norecurrent. There was no other important syndromes happened. Conclusion:DSA and interventional therapy are of great value for arterial gastrointestinal hemorrhage,especially for the cases diagnosised uncertainly or treated uneffectively by drugs.