消化道大出血急诊血管造影的价值

目的　探讨消化道出血的急诊血管造影方法和价值。资料与方法　 1 2 7例消化道出血病例均行急诊血管造影 ,对初次造影未发现出血病变的病例 ,灌注扩血管药物后再复查。据造影时临床表现和实验室检查结果 ,将出血患者分为出血活动期病例 (甲组 )和出血静止期病例 (乙组 ) ,并将两组作对比分析。结果　出血活动期病例出血查出病因的阳性率为 91 .2 % ,出血静止期病例出血查出病因的阳性率为 47.2 2 %。对首次造影未发现出血病变的病例经导管从动脉用扩血管药物后 ,未发现 1例出血。结论　消化道出血在出血活动期行急诊血管造影 ,检出阳性率明显高于出血静止期 ,两组有显著差异 (P <0 .0 0 5)。扩血管药物的应用并不能提高出血检出阳性率 ,还有降低血压、增加大出血患者低血压休克的危险性

Evaluation of Emergent Angiography for Massive Digestive Tract Hemorrhage

Objective To discuss the technique of emergent angiography and its value in detecting digestive tract bleeding.Materials and Methods Emergent angiography was performed in 127 patients with digestive tract hemorrhage. Repeated pharmaceutical angiography (infusion of vasodilator agents) was done in the patients whose initial angiograph showed no bleeding sign. According to clinical manifestations and laboratory findings before angiography, the patients were divided into group A (active bleeding period) and group B (resting period, stool occult blood test being negative). The angiographic findings in two groups were compared.Results The detecting rate for digestive tract bleeding on angiographs was 91.20% in group A and 47.22% in group B. No bleeding sign was demonstrated on all pharmaceutical angiographs.Conclusion Emergent angiography carried out in active period of digestive tract bleeding gives a higher positive rate than that performed in resting period, the difference between the two groups is statistically significant (P<0.005). Pharmaceutical angiography is of no value in improving the detective rate.