联合药物诱导DSA在小肠隐匿性出血诊疗中的临床应用研究.docVIP

精品论文 参考文献 联合药物诱导DSA在小肠隐匿性出血诊疗中的临床应用研究 梁明 何祥发 江海涛（广东省东莞市东莞康华医院放射科介入组 523080） 【摘要】 目的 探讨联合药物诱导DSA在小肠隐匿性出血的临床应用的可行性、安全性、有效性。方法 对11例常规DSA不能明确病因的小肠隐匿性出血患者，给予联合药物（尿激酶+罂粟碱）诱导DSA检查，对小肠隐匿性出血定位定性诊断，同时给予介入栓塞治疗。结果 11例患者经联合药物诱导DSA检查明确小肠出血部位、性质，并给予介入栓塞止血，与外科手术病理结论相一致。结论 联合药物诱导DSA在小肠隐匿性出血诊疗中的临床应用是可行的、安全的、有效的，对小肠隐匿性出血定位定性诊疗中有重要临床应用价值。 【关键词】 联合药物 诱导 DSA 出血 介入栓塞 【中图分类号】R57 【文献标识码】A 【文章编号】2095-1752（2013）12-0091-02 Clinical study on DSA of combined drug inducing for small intestine dormant bleeding LIANG Ming. Department of interventional radiology, Dongguan Kanghua Hospital of Guangdong Province,Dongguan 523080,China 【Abstract】Objective To evaluate the clinical feasibility,safety,and effectiveness of DSA of combined drug inducing for small intestine dormant bleeding.Methods DSA of combined drug(Urokinase+Papaverine) inducing was performed in 11 patients with small intestine dormant bleeding that wasnrsquo;t obviously showed by general DSA,by this way ,small intestine dormant bleeding was found out,and at the same time it was contolled by interventional artery embolization.Results 11 patients rsquo;arteriolar bleeding were found out and were embolized successfuliiy,. Conclusion DSA of combined drug inducing is clinically feasible,safe and effective in gastroenteric aterial bleeding,it is important value in the course of clinical application for small intestine dormant bleeding. 【Key words】 combined drug inducing DSA bleeding interventional embolization 消化道出血是临床常见病之一，大部分消化道出血经胃镜或结肠镜检查均能明确病因，但仍有近5%不明原因消化道出血（obscure gastrointestinal blooding，OGIB），即经胃镜及结肠镜等常规检查未能发现出血部位的消化道出血，其病变部位多位于小肠，最常见病因有血管畸形、平滑肌瘤、淋巴瘤、Meckel憩室、小肠Crohn病、肠结核等，对于OGIB采用影像诊断方法有：1.小肠气钡双重造影，阳性检出率为10%～44%[1,2]，2.放射性核素99mTC扫描阳性检出率为26%～78%[2],3.常规DSA造影，失血量达0.5ml/min时阳性检出率达50%～86%[3]，4.推进式小肠内镜阳性检出率达50%[2.3],5.胶囊内镜阳性检出率达87.5%[2]，我院根据患者具体病情、检查费用及所选影像检查阳性检出率综合考虑首选DSA常规造影检查，该组选择病例为经电子胃镜、结肠镜、B超及CT等影像学检查排除上消化道、结直肠及胆道病变引发出血，常规DSA造影检查未见明显活动性出血及其它异常DSA影像征象，