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目的探讨DSA诊断和栓塞治疗在消化道出血中的临床应用。方法 171例消化道出血患者行DSA,其中41例DSA阳性患者行栓塞治疗,分析DSA诊断及栓塞治疗消化道出血的临床疗效。结果 171例患者中82例DSA有阳性征象,阳性率为48.0%(82/171),包括对比剂外溢39例、假性动脉瘤23例、肿瘤染色11例、血管畸形9例。41例DSA阳性并接受栓塞治疗的患者中,39例患者成功进行栓塞治疗,技术成功率为95.1%(39/41);9例患者栓塞术后仍有活动性出血,其中3例患者再次外科手术后死亡,4例外科手术后治愈,2例因消化道出血继发多脏器功能衰竭死亡,栓塞治疗的临床成功率为73.2%(30/41)。结论 DSA对消化道出血的定位和定性诊断有重要的价值,同时栓塞治疗可安全、有效地控制消化道出血。
Objective To investigate the clinical application of DSA diagnosis and embolization in the treatment of gastrointestinal bleeding. Methods A total of 171 patients with gastrointestinal bleeding underwent DSA. Forty-one DSA-positive patients underwent embolization. The clinical efficacy of DSA in the diagnosis and treatment of gastrointestinal bleeding was analyzed. Results The positive rate of DSA in 82 cases was 48.0% (82/171) in 171 patients, including 39 cases of contrast agent spillage, 23 cases of pseudoaneurysm, 11 cases of tumor staining and 9 cases of vascular malformations. Of the 41 DSA-positive patients who received embolization, 39 patients were successfully treated with embolization with a technical success rate of 95.1% (39/41). Nine patients had active bleeding after embolization, and three of them were re-surgically treated After operation, 4 patients were cured after surgery, 2 patients died of multiple organ failure secondary to gastrointestinal bleeding. The clinical success rate of embolization was 73.2% (30/41). Conclusions DSA has important value in the localization and qualitative diagnosis of gastrointestinal hemorrhage, and embolization can control gastrointestinal bleeding safely and effectively.