介入治疗动脉性消化道大出血

目的：研究动脉性消化道大出血在保守治疗无效情况下．进行超选择动脉栓塞治疗的血管造影表现、临床应用价值及检塞技术要点。方法：本组25例均是在积极抗休克、全身止血的前提下．采用Seldinger法穿刺股动脉．首先有目的地选择某一血管造影，明确出血部位，尽快栓塞止血．普通导管难以达到栓塞部位的应用SP微导管．栓塞材料主要以明胶海绵为主．加用真丝线段、PVA颗粒、微钢圈。结果：本组25例一次栓塞成功22例。二次栓塞1例。2例栓塞后24小时仍有少量出血，给予全身止血药物出血停止。25例术后随访20～60天无1例复发出血。结论：介入治疗动脉性消化道大出血创伤小，止血快速安全．栓塞治疗目标准确．是一种有效的抢救措施。

Interventional therapy of arterial gastrointestinal hemorrhage

Objective To evaluate the angiogrophy of feature and clinical application value of superselective arterial embolotherapy in treating arterial gastrointestinal hemorrhage. Methods: 25 patients with gastrointestinal hemorrhage were performed with superselective mesenteric arteriography and interrentional embolization by gelfoam,silk coil,PVA particles and microcoil. Results:The procedures were succeeded firstly in 22 patients. One case was cured by the second time embolization. After 24 hours embolotherapy, 2 patients with continual bleeding were stopped by drug. There are no recurrent bleeding and serious complication occurred during 20-60 days in 25 cases. Conclusions:Superselective arterial embolotherapy is safe,reliable and effective for gastrointestinal hemorrhage.