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目的探讨消化道大出血经动脉造影检查,表现阴性后的进一步介入治疗措施及临床价值。方法对15例动脉造影表现阴性的消化道大出血患者根据临床表现、内镜检查结果及其它间接征象的提示行相应的介入治疗,其中9例作试验性栓塞治疗,6例给予动脉灌注止血药物。栓塞剂采用明胶海绵颗粒及钢圈,灌注药物采用立止血,立止血灌注量为2 KU(克氏单位)溶于20 m l注射用水,20 m in注完。结果试验性栓塞和灌注止血药物2种方法的出血控制率分别为66.7%(6/9)和33.3%(2/6),未见胃肠道缺血坏死等严重并发症发生。结论动脉造影表现阴性的消化道动脉性大出血,根据临床表现和内镜检查结果提示的部位,可采用试验性栓塞和动脉灌注止血药物的介入治疗方法,可有效控制出血,技术上安全可行。
Objective To investigate the further interventional measures and clinical value of hemorrhage of digestive tract after angiography. Methods Fifteen cases of patients with gastrointestinal bleeding who had negative angiography were involved in the intervention according to the clinical manifestations, endoscopic findings and other indirect signs. Nine patients underwent experimental embolization and six received arterial infusion of hemostatic agents. Embolization agent using gelatin sponge particles and steel ring, infusion of anti-stop bleeding with blood, standing stop bleeding perfusion volume of 2 KU (Krypton) dissolved in 20 ml of water for injection, 20 mins Note finished. Results The bleeding control rates of the two methods of experimental embolization and infusion of hemostatic drugs were 66.7% (6/9) and 33.3% (2/6) respectively. No serious complications such as gastrointestinal ischemic necrosis were found. Conclusion According to the clinical manifestations and endoscopic findings, experimental arterial embolization and arterial infusion of hemostatic drugs interventional therapy can be used, which can effectively control the bleeding, technically safe and feasible.