【作者】 刘振玉； 张雪松；

【Author】 LIU Zhenyu ZHANG Xuesong (Jiamusi University First Affiliated Hospital,Interventional Radiology,Heilongjiang 154002,China)

【机构】 佳木斯大学附属第一医院介入放射科；

【摘要】 目的探讨选择性动脉造影诊断和介入治疗顽固性消化道出血的方法及疗效。材料与方法顽固性消化道出血5例,均为男性,年龄12～60岁。其中上消化道5人次,下消化道1人次。术前30 min 应用镇定剂,同时肌注非那根25mg。采用 Seldinger 技术,经右侧股动脉穿刺插管,使用4F、5F RH 或 SIMMONS 导管,常规行腹主动脉、腹腔动脉、肠系膜上、下动脉造影。在明确出血部位和供血动脉及出血原因后.根据解剖学上的供血特点,进行栓塞或/和药物灌注治疗。术中输液或输血维持血容量,术后抗炎、补液、护肝、保护胃黏膜等对症治疗,严格观察生命指征及24～48 h 尿量。结果 5例患者共做了6次介入治疗,止血均获得了成功。结论选择性动脉造影诊断和栓塞及药物灌注治疗顽固性消化道出血,方法简单明确方便,能够明确诊断,有目的地栓塞出血血管,为消化道出血提供了一个有效的止血措施。介入栓塞及药物灌注治疗消化道出血创伤小,效果迅速可靠,对此类患者可起到挽救生命的作用。更多还原

【Abstract】 Objective To evaluate the method and efficacy of sele-ctive angiography diagnosis and interventional treatment of refrac-tory gastroin- testinal bleeding.Materials and Methods Five men p-atients affect in- tractable gastrointestinal bleeding,with age betwee-n 12 and 60,which five of them bear the upper digestive tract blee-ding,one bears lower di- gestive tract bleeding.These patients are a-pplied Tranquillizers before the operation thirty minutes and injec-ted non-Flanagan 25 ms intramus- cular at the same time.We apply the technology of Seldinger to puncture the right femoral artery by the way of 4F,5F RH or SIMMONS catheter and carry out the co-ntrast imaging of abdominal aorta,celiac artery,the superior and inferior mesenteric conventionally.After definiting the bleeding position,blood-supply artery and causes,according to anatomi- cal features of the blood supply we proceed embolism and/or drugs perfu- sion treatment.In the operation using blood and transfusion to maintain the blood volume,after that we use the symptomatic treatment such as an- ti-inflammatory,rehydration,liver protecting and the protection of gastric mucosa eta,and strictly observe the indications of life and 24 h—48 h u- rine.Results Five cases of patients with a total of six times to intervene in the treatment of bleeding have been successful.Conclusion The way that selective angiography diagnosis and embolism and drugs perfusion therapy refractory gastrointestinal bleeding is simple and convenient, which can make a clear diagnosis.The purpose of vascular thrombosis bleeding provides an effective method to stop gastrointestinal bleeding. Embolization and drugs in the treatment of gastrointestinal bleeding can make wounds small,fast,and get reliable results,which can play an im- portant role in savin8 lives of such patients.更多还原