CAJ | 학술논문

目的探讨外科术后腹部出血(包括腹腔、腹膜后、消化道)的数字减影血管造影(digital subtraction angiography,DSA)表现和介入治疗的临床价值.方法 2003年6月至2009年6月间,24例外科术后怀疑腹部出血的患者接受了DSA造影检查和介入治疗.回顾性分析外科术后腹部出血的数字减影血管造影表现和介入治疗方法,比较介入术前和术后3 d血红蛋白、红细胞压积、血压和心率变化.计量资料使用均数±标准差(-x±s)表示,使用配对t检验对相关指标进行比较,统计软件使用SPSS 11.0.结果经DSA造影检查后,24例患者均明确了出血原因和出血部位.其中22例进行介入治疗后出血即刻停止(92%,95%CI:63%～99%)且30 d内未复发,2例疗效不佳行外科手术治疗.经介入治疗的患者未出现介入相关并发症.术后3 d患者血红蛋白、红细胞压积、收缩压和舒张压增高(t=7.564,P=0.000;t=6.616,P=0.000;t=6.051,P=0.000;t=8.579,P=0.000),心率降低(t=11.050,P=0.000).结论 DSA能够明确外科术后腹部出血的原因和部位;介入栓塞治疗安全、有效,具有重要的临床应用价值,值得大力推广.
목적 탐토외과술후복부출혈(포괄복강、복막후、소화도)적수자감영혈관조영(digital subtraction angiography,DSA)표현화개입치료적림상개치.방법 2003년6월지2009년6월간,24예외과술후부의복부출혈적환자접수료DSA조영검사화개입치료.회고성분석외과술후복부출혈적수자감영혈관조영표현화개입치료방법,비교개입술전화술후3 d혈홍단백、홍세포압적、혈압화심솔변화.계량자료사용균수±표준차(-x±s)표시,사용배대t검험대상관지표진행비교,통계연건사용SPSS 11.0.결과 경DSA조영검사후,24례환자균명학료출혈원인화출혈부위.기중22례진행개입치료후출혈즉각정지(92%,95%CI:63%～99%)차30 d내미복발,2례료효불가행외과수술치료.경개입치료적환자미출현개입상관병발증.술후3 d환자혈홍단백、홍세포압적、수축압화서장압증고(t=7.564,P=0.000;t=6.616,P=0.000;t=6.051,P=0.000;t=8.579,P=0.000),심솔강저(t=11.050,P=0.000).결론 DSA능구명학외과술후복부출혈적원인화부위;개입전새치료안전、유효,구유중요적림상응용개치,치득대력추엄.
Objective To discuss the clinical value of digital subtraction angiography(DSA)and interventional therapy in the abdominal exsanguinations including intra-abdominal hemorrhage,retroperitoneal hemorrhage and gastrointestinal hemorrhage secondary to surgery.Method From June 2003 to June 2009,a total of 24 patients with doubtful abdominal exsanguinations underwent DSA examination and received interventional therapy.The imaging of DSA and the efficacy were retrospectively analyzed.The hemoglobin,hemtocdt,blood pressure,and heart rate before and 3 days after operation were compared.The measurement data were analyzed using pairedsamples t-test,and the SPSS version 11.0 software was used for statistical analysis.Results The diagnosis of causes and site of post-opelative bleeding were entirely depended upon DSA examinations.All the patients accepted interventional therapy in the same session.Twenty-two patients(92%,95%C1:63%～99%)got rid of bleeding immediately without recurrence in 30 days,and two patients underwent re-surgical intervention because of bleedins recurrence within 24 hours.There were no complications of intervention found.The increases in levels of hemoglobin,hematocrit and blood pressures were observed(t=7.564,P=0.000;t=6.616,P=0.000;t=6.051,P=0.000;andt=8.579,P=0.000,respectively),and the heart rate was decreased(t=11.050,P=0.000).Conclusioms The DSAcandetennine the causesand the sites of post-operative bleeding,and the intervenfionai therapy is safe and effective with great clinical values,being worthy to extending in a large scale of application.