动脉造影阴性的消化道大出血的试验性栓塞治疗指征和疗效

目的 探讨试验性栓塞对造影阴性的动脉性消化道大出血的指征和疗效。资料与方法 对150例消化道大出血患者根据临床表现和内镜检查结果提示行相应动脉造影，阴性者64例作试验性栓塞治疗，其中胃十二指肠动脉52例，胃左动脉6例，直肠上动脉2例，直肠下动脉4例，栓塞剂采用明胶海绵颗粒及钢圈。结果 栓塞技术成功率为100%，出血控制率为56%（36/64），未见胃肠道缺血坏死等严重并发症发生。结论 动脉造影阴性的消化道大出血根据临床表现和内镜检查结果提示的部位行试验性栓塞可控制部分出血，且技术上较安全可行。

Trial Embolismic Therapy for Massive Gastrointestinal Hemorrhage with Negative Arteriographic Result: Indication and Efficacy

Objective To investigate the indication and efficacy of trial arterial embolization for the massive gastrointestinal hemorrhage with normal angiographic result. Materials and Methods Arteriography was performed in 150 patients with massive gastrointestinal hemorrhage, of which negative angiographic result was seen in 64. Trial embolismic therapy was carried out in these 64 cases, including embolization of gastroduodenal artery (n=52), left gastric artery (n=6), superior rectal artery (n=2) and inferior rectal artery (n=4). Gelfoam particles and steel coil were used as embolizing agents. Results The technical success rate was 100%, while the control rate of hemorrhage was 56% (36/64). No severe complications, such as gastrointestinal ischemia or infarction, occurred. Conclusion In the treatment of massive gastrointestinal hemorrhage with normal angiographic result, trial embolization of the possible diseased arteries suggested by clinical manifestations and endoscopic findings can control the hemorrhage in some patients. Technically, this procedure is feasible and safe.