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近年来,我院对5例疑难性消化道出血病人进行了腹部动脉造影栓塞术。现结合我们的体会分析讨论如下。 1 病历摘要例1.男,39岁。因肝内外胆管结石,行胆道探查取石,肝左外叶切除,胆管空肠Roux-Y吻合术。术后10天出现重症胆管炎,腹腔脓肿,腹腔霉菌感染,肠瘘等并发症。于术后第8周出现T管出血,呕血、黑便,同时伴有上腹部绞痛、高热、黄疸加重。失血量24小时达2000ml,并出现休克。给止血剂、输血、抗感染无效,急诊行选择性肝动脉造影,在肝右动脉第一分支处见有造影剂外溢。用明胶海绵细末栓塞不能止血,加用螺旋钢圈后,止血成功。
In recent years, our hospital for 5 cases of intractable gastrointestinal bleeding patients with abdominal arteriography embolization. Now with our experience analysis and discussion are as follows. 1 medical records summary 1. Male, 39 years old. Due to intrahepatic bile duct stones, biliary exploration stone, left hepatic resection, Roux-Y bile duct jejunostomy. Ten days after surgery, severe cholangitis, abdominal abscess, peritoneal mildew infection, intestinal fistula and other complications. In the 8th week after operation, T-tube hemorrhage, hematemesis and melena appeared, accompanied by upper abdominal cramps, fever and aggravating jaundice. 24 hours blood loss reached 2000ml, and shock. To hemostatic, blood transfusion, anti-infective invalid, emergency line selective hepatic artery angiography, in the first branch of the right hepatic artery see a contrast agent spillover. Gelatin sponge fine embolization can not stop bleeding, add spiral steel ring, stop bleeding.