内镜难治性胃肠道出血介入诊疗的安全性和有效性

发布时间：2018-12-12 15:42

【摘要】：目的评价内镜难治性胃肠道出血介入诊疗的安全性和有效性。方法对31例内镜难治性胃肠道出血患者行DSA检查,明确出血部位后行出血动脉栓塞治疗,并评价其安全性和疗效。结果血管造影发现出血阳性率为80.65%(25/31),28例行栓塞止血治疗,1次栓塞止血成功率75.00%(21/28),2次栓塞总成功率82.14%(23/28)。7例介入术后行外科手术,包括2例空肠间质瘤及5例胃恶性肿瘤。4例胃恶性肿瘤患者介入术后30日内再发间断出血,其中2例因基础疾病致心肺衰竭死亡。除1例胃肠吻合术后吻合口出血患者栓塞止血术后出现吻合口瘘,经支持治疗后恢复出院,余患者未出现严重胃肠缺血坏死。结论介入诊疗对胃肠道出血的诊断及止血治疗高效、安全,尤其对胃恶性肿瘤出血亦能取得良好效果,可作为内镜难治性胃肠道出血的一种较好的诊治手段。
[Abstract]:Objective to evaluate the safety and efficacy of endoscopic interventional diagnosis and treatment of intractable gastrointestinal hemorrhage. Methods 31 patients with intractable endoscopic gastrointestinal bleeding were examined by DSA. The bleeding artery embolization was performed after the location of bleeding was determined and its safety and efficacy were evaluated. Results the positive rate of bleeding was 80.65% (25 / 31) by angiography, 28 cases were treated with embolization and hemostasis, the success rate of one embolization was 75.00% (21 / 28). The total success rate of twice embolization was 82.14% (23 / 28). 7 cases underwent surgical operation after interventional operation, including 2 cases of jejunal stromal tumor and 5 cases of gastric malignant tumor. 4 cases of gastric malignant tumor patients suffered from recurrent bleeding within 30 days after interventional operation. Two of them died of cardiopulmonary failure due to underlying diseases. Except for one case of anastomotic bleeding after gastroenterostomy, anastomotic leakage occurred after embolization and hemostasis, and recovered after supportive treatment. Conclusion Interventional diagnosis and treatment are effective and safe in the diagnosis and hemostasis of gastrointestinal bleeding, especially for gastric malignant tumor bleeding, and can be used as a better method for the diagnosis and treatment of endoscopy refractory gastrointestinal bleeding.
【作者单位】：南京中医药大学附属医院介入医学科;
【分类号】：R573.2

【相似文献】