下消化道出血DSA诊断及栓塞结合小剂量垂体后叶素灌注治疗

目的 探讨不明原因下消化道出血的DSA诊断及介入栓塞治疗的临床应用价值。方法 对32例不明原因下消化道出血患者行DSA检查，通过显示造影剂铃溢、病理血管和肿瘤染色来确定出血原因及部位，对出血处行超选择性动脉栓塞治疗和留置导管灌注小剂量垂体后叶素维持12h止血治疗。结果 DSA诊断阳性率75％（24132），其中肠伤寒2例，肠结核1例，血管性病变14例，肿瘤7例。阳性者介入手术成功20例，手术成功率83．3％，无一例严重并发症。结论 DSA检查和介入治疗对诊断不明确或保守治疗无效的下消化道出血有着重要的诊断及治疗价值，超选择性动脉栓塞后小剂量垂体后叶素灌注治疗安全、有效。

The DSA diagnosis, artery embolization combined with low dose of vasopressin infusion treatment for lower digestive tract hemorrhage

Objective To evaluate the clinical value of digital subtraction angiography (DSA)diagnosis and interventional treatment for lower digestive tract hemorrhage of unknown reasons.Methods DSA was performed in 32 patients with unknown etiologic lower digestive tract hemorrhage. The locations and causes of hemorrhage were determined by angiography according to the demonstration of contrast medium extravasation, abnormal vasculature and tumor staining. Superselective arterial embolization was performed with retaining catheter of low dose vasopressin infusion for 12 hours of hemostasis. Results Seventy-five percent of the lesions were identified by DSA with 2 cases of intestinal typhoid,1 intestinal tuberculosis,14 cases of vascular malformation and 7 cases of tumor. Hemostasis was succeeded in 20 of 24 patients. The rate of success was 83.3%.Conclusions DSA and interventional therapy are of great value in diagnosing and treating patients with lower digestive tract hemorrhage of unknown reasons and even those undergone unsuccessful conservative treatment. Low dose vasopressin infusion through retained catheter is safe and efficient after superselective arterial embolization.