难治性消化道出血的DSA诊断和介入治疗11例.docVIP

难治性消化道出血的DSA诊断和介入治疗11例 作者：汤淼，王刚，周建承Δ，文丽彬 作者单位：337000 江西萍乡，湘雅萍矿合作医院内镜室（Δ放射科） 【摘要】 目的 评价难治性消化道出血的DSA诊断和介入治疗的临床应用价值。方法 对11例难治性消化道出血的患者进行选择性插管及超选择插管数字减影血管造影术分析，并对造影阳性者采用靶血管栓塞或靶血管药物灌注治疗。结果 11例患者DSA均显示阳性，其中首次血管造影显示造影剂外溢征象者10例，应用出血诱发试验后再次血管造影显示造影剂外溢征象者1例。11例患者中胃十二指肠动脉出血5例，胰十二指肠动脉出血2例，胃左动脉出血2例，肠系膜上动脉空肠分支出血2例。动脉栓塞治疗8例，垂体后叶素灌注治疗3例。11例患者介入治疗后造影均未见对比剂外溢征象，术后无并发症发生，1周内未复发。结论 DSA诊断难治性消化道出血有很高的价值，介入治疗是治疗难治性消化道出血的一种安全、有效的方法。 【关键词】 难治性消化道出血；DSA；介入治疗 Refractory hemorrhage of digestive tract in 11 cases with DSA diagnosis and interventional therapy TANG Miao, WANG Gang, ZHOU Jian-cheng, et al.Department of Endoscope, Xiangya and Pingxiang Mining Cooperation Hospital, Pingxiang 337000,China 【Abstract】 Objective To make an evaluation on clinical application value of DSA diagnosis and interventional therapy for refractory hemorrhage of digestive tract. Methods 11 patients suffered from refractory hemorrhage of digestive tract were reviewed with selective catheterization and super selective catheterization digital subtraction angiography, and the patients with positive signs would be treated with embolization or drug injection into target vessels.Results All patients reviewed by DSA obtained positive signs, and 10 cases showed the symptom of contrast media extravasation by using angiography technology for the first time, 1 case got the same result after hemorrhage provocative test. Among of those 11 cases, 5 patients happened arterial hemorrhage in gastroduoden, 2 patients in pancreas-duodenum, 2 patients in left gastric artery, 1 patient in jejunum branch of superior mesenteric artery. 8 patients were cured with arterial embolization, and 3 patients were cured with hypophysin injection. All the patients did not show the symptom of contrast media extravasation and any complications and no recurrence was found in a week after interventional therapy. Conclusion The clinical application value of DSA diagnosis produces high value and interventional ther