DSA诊断不明原因下消化道出血.pdf

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1、中国介入影像与治疗学2014年第11卷第9期ChinJIntervImagingTher，2014，Vol11，No9·565·DSAindiagnosisoflowerdigestivetracthemorrhagewithunknowncauseF【，Zhi—gang，ZHANGXiao—lin，y【，Cheng—xin，LIHai—tao，ZHANGZhi—gang，WANGJun，ZHA0Yun—yun(DepartmentofInterventionalRadiology，theFirstCollegeofClinicalMed

2、icalScience，ChinaThreeGorgesUniversity，YichangCentralPeople~Hospital，Yichang443003，China)[Abstract]ObjectiveToevaluatethediagnosticvalueofDSAforlowerdigestivetracthemorrhagewithunknowncause．MethodsEighteenconsecutivepatientsofacuteorchronicrecurrentgastrointestinalhemorrh

3、agewithunknowncausewerecollected．RightfemoralarterywaspuncturedusingSeldingertechniqueinallthe18patients，andselectiveangiographywasusedtotheceliac，superiormesentericartery，superiormesentericarteryandinternaliliacarterywith5FYashirocath—eter．Superselectivecatheterangiograp

4、hywith3Fmicrocatheterwasperformedforsomeofsuspectedlesions．ForpatientswithpositiveDSAresults，thecatheterwaskeptintargetvessel，andthepatientsweresenttosurgicaloperation．Gelatinspongeparticleswereusedforembolizationinpatientswithindications．ResultsThepositiverateofDSAwas66．

5、67(12／18)．Extravasationofcontrastagentwasfoundin5patientsasdirectfeatureofbleeding．Indirectsignsofbleedingin—cludedtumorousvascularityandblush(n一2)andvascularlesions(一5)．DSAshowednegativesignsin6patients．Bleedingstoppedimmediatelyin5patientsafterembolization．ConclusionDSA

6、hasimportantvalueindiagnosisoflowerdigestivetracthemorrhagewithunknowncause．[Keywords]Gastrointestinaltract；Hemorrhage；Angiography，digitalsubtraction；Diagnosticimaging；Embolization，therapeuticDSA诊断不明原因下消化道出血付志刚，张晓磷，余成新，李海涛，张志刚，王俊，赵云云(三峡大学第一临床医学院宜昌市中心人民医院介入放射科，湖北宜昌443003)[

7、摘要]目的探讨DSA诊断不明原因下消化道出血的价值。方法对18例临床诊断不明确的急性或慢性反复消化道出血患者行DSA，穿刺右侧股动脉后，将5FYashiro导管选择性插管至腹腔干、肠系膜上动脉、肠系膜下动脉以及髂内动脉造影，对部分疑有病变部位以3F微导管行超选择性插管造影。造影有阳性发现时，保留靶血管内导管，将患者送往外科手术}对有栓塞适应证者使用明胶海绵颗粒栓塞止血。结果血管造影阳性率为66．67(12／18)；5例可见对比剂外溢，间接征象包括肿瘤血管及染色2例，血管性病变5例。6例DSA阴性。5例经导管栓塞后即刻止血。结论DSA对不明

8、原因下消化道出血具有重要诊断价值。[关键词]胃肠道；出血；血管造影术，数字减影；诊断显像I栓塞，治疗性[中图分类号]R57；R816[文献标识码]A[文章编号]1672—8475(2014)0