CAJ | 학술논문

目的：探讨术前超选择性肠系膜动脉造影(SSMA)联合术中美蓝注射对不明原因消化道出血(OGIB)的定位价值。方法12例 OGIB 患者术前均行 SSMA,血管造影明确出血部位后将微导管保留于出血动脉分支内,继而在剖腹探查术中经微导管注射美蓝进行定位,切除被染色的肠管。结果12例患者术前 SSMA 出血部位检出率为100%。全部病变肠管均于手术中迅速被发现,切除肠管长度9~12 cm (平均10 cm)。术后随访10~24月(平均18月),没有复发肠道出血。结论术前 SSMA 联合术中美蓝注射的方法,有助于明确 OGIB 部位,增加手术止血成功率,是一种安全、高效的 OGIB 定位方法。
목적：탐토술전초선택성장계막동맥조영(SSMA)연합술중미람주사대불명원인소화도출혈(OGIB)적정위개치。방법12례 OGIB 환자술전균행 SSMA,혈관조영명학출혈부위후장미도관보류우출혈동맥분지내,계이재부복탐사술중경미도관주사미람진행정위,절제피염색적장관。결과12례환자술전 SSMA 출혈부위검출솔위100%。전부병변장관균우수술중신속피발현,절제장관장도9~12 cm (평균10 cm)。술후수방10~24월(평균18월),몰유복발장도출혈。결론술전 SSMA 연합술중미람주사적방법,유조우명학 OGIB 부위,증가수술지혈성공솔,시일충안전、고효적 OGIB 정위방법。
Objective To discuss the value of combining superselective mesenteric angiography (SSMA)with methylene blue in-jection for localization of the Obscure Gastrointestinal Bleeding (OGIB).Methods 12 patients presenting with OGIB had preopera-tive localization of the bleeding site by SSMA.The microcatheter was remained inside the bleeding artery branch after angiography. Then the methylene blue was injected via the microcatheter for localization during exploratory laparotomy and the dyed intestine was then removed.Results The detected rate of bleeding sites by using preoperative SSMA was 100%.The lesions in total 12 patients were found quickly during the exploratory laparotomy.The length of the removed intestine was 9 -12 cm (median,10 cm).After followed up for 10-24 months (median,18 months),all patients with OGIB had no recurrence.Conclusion The method of SSMA combined with the use of methylene blue injection is a safe and effective procedure for the localization of OGIB and could be beneficial for increasing the surgical success rate of hemostasis.