| 袁磊 陈波 许潭潭 史东宏 曹建民 卢光明 许健.数字减影血管造影用于重症胰腺炎并发出血患者诊断及介入治疗[J].,2014,14(19):3680-3683 |
| 数字减影血管造影用于重症胰腺炎并发出血患者诊断及介入治疗 |
| Diagnosis and Interventional Treatment of Digital Subtraction Angiographyfor Patients with Hemorrhagic Complication of Severe Pancreatitis |
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| DOI： |
| 中文关键词: 重症胰腺炎 数字减影血管造影 动脉栓塞 出血 |
| 英文关键词: Severe pancreatitis Digital Subtraction Angiography Transcatheter arterial embolization Hemorrhage |
| 基金项目:国家自然科学基金项目（81300360） |
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| 中文摘要: |
| 目的：探讨数字减影血管造影(Digital Subtraction Angiography, DSA)诊断及介入治疗重症胰腺炎（Severe panreatitis, SP）并发
出血的临床疗效。方法：回顾性分析2009 年1 月-2013 年11 月南京军区总医院收治的42 例SP 并发出血患者行动脉造影，发现
出血征象时采用微钢圈配合明胶海绵栓塞或经导管灌注缩血管药治疗。观察选择性动脉造影对诊断出血部位及止血效果的价
值。结果：通过造影42 例患者中28 例发现出血征象，出血阳性率为66.7 %（28/42），25 例通过超选择栓塞以控制出血，初次止血
率89.2 %（25/28）。6 例栓塞后复发出血，再出血率为24.0 %（6/25），4 例再行栓塞成功，再止血成功率为66.7 %，累计止血成功率
为82.1 %。3例栓塞后反复出血未能控制，死于多器官功能衰竭,1 例栓塞后脾脓肿并行脾切除，1 例栓塞后肠缺血。结论：DAS不
仅可以快速诊断出血部位，还可以同时进行介入治疗，止血效果肯定。 |
| 英文摘要: |
| Objective:To investigate the value of diagnosis and interventional treatment of digital subtraction angiography(DSA)
for patients with hemorrhagic complication of severe pancreatitis.Methods:During the period from January 2009 to November 2013, a
total of 42 patients with hemorrhagic complication of severe pancreatitis, were admitted to authors, hospital. Angiography were carried
out in all the patients. The target vessels were embolized by gelfoamand microcoil or were infused vasopressin via catheter. The value of
selective arteriography in diagnosis of the bleeding site, and the efficacy of hemostasis were analyzed.Results:28 cases of bleeding sites
found by angiography, diagnosis of bleeding was 66.7 %（28/42）. Bleeding was controlled in 25 cases with ultraselective embolism. TAE
successful hemostasis was 89.2 %（25/28）rebleeding rate was 24.0 %（6/25）. The successful rate of TAE again was 66.7% (4/6), with
overall success rate of 82.1 %. Three cases of recurrent bleeding after embolization failed to control, died of multiple organ failure. One
case of splenic abscess after embolization, and another one case of avascular necrosis of the intestine.Conclusion:DAS can not only
diagnose quickly the bleeding site, but can also be used simultaneously in intervention with good hemostasis effect. |
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