超选择性动脉栓塞术可控制急性下消化道出血。,World Journal of Clinical Cases

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超选择性动脉栓塞术可控制急性下消化道出血。
World Journal of Clinical Cases ( IF 1.0 ) Pub Date : 2019-11-26 , DOI: 10.12998/wjcc.v7.i22.3728
Liang-Shan Lv ₁ , Jing-Tao Gu ₂

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背景技术急性胃肠道出血是一种紧急情况，其可导致明显的发病率和死亡率。当在该人群中进行手术或加压素输注不现实时，栓塞术被认为是治疗下消化道出血的首选疗法。由于认为这种情况下肠梗塞的风险极高，因此使用这种技术治疗急性下消化道（GI）出血（Treitz韧带以下的任何部位）尚未达成共识。这项研究的目的是在回顾性组接受栓塞治疗的急性下消化道出血患者中评估该技术的有效性和安全性。目的评估超选择性动脉栓塞治疗急性下消化道出血的疗效和安全性。方法回顾性分析了连续31例经血管造影证实为小肠或结肠出血的患者。记录超选择性栓塞术的成功率和并发症发生率。结果31例患者中有5例（16.1％）无法实现足够的选择性导管插入术以允许栓塞。最初的出血控制在26例患者中（100％），并且术后1周时有1例复发了GI出血。在栓塞患者中未观察到临床上明显的肠梗塞。结论超选择性栓塞术是急性下消化道出血的安全治疗方法，对于许多患有这种疾病的患者而言，它是合适且有效的。重要的是，仔细的技术和合适的栓塞剂对于成功手术至关重要。

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Super-selective arterial embolization in the control of acute lower gastrointestinal hemorrhage.

BACKGROUND Acute gastrointestinal bleeding is an emergency condition that can lead to significant morbidity and mortality. Embolization is considered the preferred therapy in the treatment of lower gastrointestinal bleeding when it is unrealistic to perform the surgery or vasopressin infusion in this population. Treatment of acute lower gastrointestinal (GI) bleeding (any site below the ligament of Treitz) using this technique has not reached a consensus, because of the belief that the risk of intestinal infarction in this condition is extremely high. The purpose of the study is to evaluate the effectiveness and safety of this technique in a retrospective group of patients who underwent embolization for acute lower GI bleeding. AIM To evaluate the efficacy and safety of super-selective arterial embolization in the management of acute lower GI bleeding. METHODS A series of 31 consecutive patients with angiographically demonstrated small intestinal or colonic bleeding was retrospectively reviewed. The success rate and complication rate of super-selective embolization were recorded. RESULTS Five out of thirty-one patients (16.1%) could not achieve sufficiently selective catheterization to permit embolization. Initial control of bleeding was achieved in 26 patients (100%), and relapsed GI bleeding occurred in 1 of them at 1 wk after the operation. No clinically apparent bowel infarctions were observed in patients undergoing embolization. CONCLUSION Super-selective embolization is a safe therapeutic method for acute lower GI bleeding, and it is suitable and effective for many patients suffering this disease. Importantly, careful technique and suitable embolic agent are essential to the successful operation.

更新日期：2019-11-26

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