中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
26期
16-17
,共2页
上消化道出血%胃镜%血管造影%栓塞
上消化道齣血%胃鏡%血管造影%栓塞
상소화도출혈%위경%혈관조영%전새
Upper digestive hemorrhage%Gastroscopy%Angiography%Embolization
目的：探讨胃镜及放射介入联合诊疗的临床实用价值。方法：收集笔者所在医院2011年7月-2013年12月期间临床诊断急性上消化道出血，行胃镜及DSA血管造影检查均未见活动性出血，且经内科保守治疗无效的患者16例。胃镜检查的同时排除食管胃底静脉曲张破裂出血，并查找到可能出血的溃疡部位。依据溃疡病灶的部位，DSA引导下超选择性插管明胶海绵颗粒栓塞相应部位的供血动脉。结果：所有16例患者中11例出血停止；3例出血量减少；2例止血无效，转外科手术探查。栓塞治疗止血率达68.7%，有效率87.5%。结论：放射介入血管栓塞与胃镜检查相结合，可明显提高治疗有效率，降低死亡率，对难治性上消化道溃疡动脉性出血患者的治疗有重大的临床应用价值，值得在临床上广泛推广应用。
目的：探討胃鏡及放射介入聯閤診療的臨床實用價值。方法：收集筆者所在醫院2011年7月-2013年12月期間臨床診斷急性上消化道齣血，行胃鏡及DSA血管造影檢查均未見活動性齣血，且經內科保守治療無效的患者16例。胃鏡檢查的同時排除食管胃底靜脈麯張破裂齣血，併查找到可能齣血的潰瘍部位。依據潰瘍病竈的部位，DSA引導下超選擇性插管明膠海綿顆粒栓塞相應部位的供血動脈。結果：所有16例患者中11例齣血停止；3例齣血量減少；2例止血無效，轉外科手術探查。栓塞治療止血率達68.7%，有效率87.5%。結論：放射介入血管栓塞與胃鏡檢查相結閤，可明顯提高治療有效率，降低死亡率，對難治性上消化道潰瘍動脈性齣血患者的治療有重大的臨床應用價值，值得在臨床上廣汎推廣應用。
목적：탐토위경급방사개입연합진료적림상실용개치。방법：수집필자소재의원2011년7월-2013년12월기간림상진단급성상소화도출혈，행위경급DSA혈관조영검사균미견활동성출혈，차경내과보수치료무효적환자16례。위경검사적동시배제식관위저정맥곡장파렬출혈，병사조도가능출혈적궤양부위。의거궤양병조적부위，DSA인도하초선택성삽관명효해면과립전새상응부위적공혈동맥。결과：소유16례환자중11례출혈정지；3례출혈량감소；2례지혈무효，전외과수술탐사。전새치료지혈솔체68.7%，유효솔87.5%。결론：방사개입혈관전새여위경검사상결합，가명현제고치료유효솔，강저사망솔，대난치성상소화도궤양동맥성출혈환자적치료유중대적림상응용개치，치득재림상상엄범추엄응용。
Objective:To discuss the clinical practical value of gastroscopy and interventional radiology combined diagnosis.Method:Collecting 16 cases who clinical diagnosis of acute upper digestive hemorrhage,gastroscopy and DSA angiography showed no active bleeding,and failed in conservative treatment in our hospital from July 2011 to December 2013.Maked a gastroscopy and excluded the gastric varicosis esophagus bleeding,and find out the possible bleeding ulcer location.According to the position of ulcer lesion,DSA was used to guide super-selective catheterization gelatin sponge embolize of relevant parts of the bleeding artery.Result:In all 16 cases,11 cases bleeding stopped,3 cases blood loss reduction,2 cases hemostasis invalid and turn to surgical operation. Embolization bleeding success rate was 68.7%,and effective rate was 87.5%.Conclusion:Combination radiological interventional diagnose and gastroscopy,which can significantly improve the treatment efficiency,and reduce the mortality rate.In the treatment of patients with refractory ulcer of upper digestive tract arterial hemorrhage,it had a great clinical application value and deserved to be widely applied in clinical practice.
