目的探讨 DSA 检查和栓塞治疗对消化道出血的诊断和治疗价值。方法 20例消化道出血患者行腹腔动脉、肠系膜上动脉和肠系膜下动脉造影,对可能出血部位及造影过程中可疑之处再行超选择性插管造影,其中10例经造影明确诊断,出血动脉显示清晰的患者在超选择插管基础上进行栓塞治疗,栓塞材料为明胶海绵颗粒5例,明胶海绵+弹簧圈2例,聚乙烯醇微粒(PVA)3例。结果 20例中13例造影出现阳性征象,主要表现为对比剂外溢6例,动脉瘤5例,局部肿瘤血管和肿瘤染色2例,动脉侵蚀1例,局部血管痉挛1例。10例接受栓塞治疗的患者中8例出血停止,30 d 内无再出血,无肠缺血、肠坏死等并发症,1例栓塞后次日死于多器官功能衰竭,1例栓塞后3 d 出血复发,经外科手术治疗痊愈。结论 DSA 检查对于急性活动性消化道出血有着较好的诊断效果,尤其是对血管性病变、肿瘤引起的消化道出血诊断效果较好。栓塞治疗对于控制出血安全有效。 Objective To investigate the value of DSA examination and embolization in the diagnosis and treatment of gastrointestinal bleeding. Methods Twenty cases of patients with gastrointestinal hemorrhage underwent celiac artery, superior mesenteric artery and inferior mesenteric artery angiography. The site of possible hemorrhage and suspicion of angiography were followed by superselective catheterization. Among them, 10 cases were confirmed by angiography, and the bleeding artery Clearly demonstrated patients underwent transcatheter embolization based on superselective intubation. The embolic material was gelatin sponge particles in 5 cases, gelatin sponge + coil in 2 cases, polyvinyl alcohol particles (PVA) in 3 cases. Results Of the 20 cases, 13 cases showed positive signs of angiography. The main manifestations were as follows: 6 cases of contrast agent overflow, 5 cases of aneurysm, 2 cases of local tumor blood vessel and tumor staining, 1 case of arterial erosion and 1 case of local vasospasm. Among the 10 patients who received embolization, bleeding stopped in 8 patients, no rebleeding, no intestinal ischemia and other complications occurred within 30 days. One patient died of multiple organ failure the next day after embolization, and one patient died after 3 days of embolization Bleeding recurrence, healed by surgical treatment. Conclusion DSA has a good diagnostic value for acute active gastrointestinal bleeding, especially for the diagnosis of vascular lesions and gastrointestinal bleeding caused by tumors. Embolization is safe and effective in controlling bleeding.