摘要
目的:探讨空回肠出血介入治疗的安全栓塞部位和明胶海绵的直径。方法:回顾性分析17例空回肠出血的介入栓塞资料,其中7例拟介入术后手术者分为2组。A组4例,小肠肿瘤及血管畸形各2例,以明胶海绵微粒(直径约0.2 mm)栓塞;B组3例,小肠肿瘤1例,血管畸形2例,以明胶海绵颗粒(直径约0.5-1 mm)栓塞。在2组手术后,另有10例为散在出血,以B组方法栓塞。结果:17例均取得了即时止血的疗效。A组4例手术显示栓塞段局部肠坏死,明胶海绵微粒位于直动脉的肠壁干及其分支内,B组栓塞部位为小肠动脉弓1-3级(近、中级),3例小肠肿瘤及血管畸形手术未见肠坏死,仅见栓塞肠段呈轻度缺血改变,10例未行手术者,随防6-12个月未见肠坏死,未见再出血。结论:空回肠出血的安全栓塞部位为小肠动脉弓1-3级(近、中级),明胶海绵颗粒(直径约0.5-1 mm)是安全的栓塞剂。
Objective： To probe the safe site and appropriate gelfoam diameter in the emolization therapy of jejuno-ileum hemorrhage. Methods： Seventeen cases wit interventional h jejuno-ileum hemorrhage were preformed intervetional embolization and the data were analyzed retrospectively. Seven cases that were accepted surgical operation were divided into two groups. Group A involves two cases of enteric tumor and two casses of vascular deformity respectively, which were embolized by gelfoam mote （0.2 mm in diameter）. Group B include one case of enteric tumor and two cases of vascular deformity that were embolized by gelfoam grain （0.5-1 mm in diameter）. There were another 10 cases of disseminated hemorrhage and were embolized with the same method as Group B did. Results： Hemostasia occurred in all of the 17 cases shortly after the interventional therapy. The four cases in Group A showed partial intestinal necrosis in embolismic section. The gelfoam mote located in the parietal stem of straight arteries and reticular branch of intestinal wall. The embolismic sites were in grade 1-3 enteric arterial arches （the near and middle degree） in Group 13. No intestinal necrosis appeared in three cases of enteric tumor and vascular deformity, but slight ischemia could be observed in embolismic sections. Ten cases without inter-ventional therapy showed no enteric necrosis and hemorrhage in the follow-up of 6-12 months. Conclusion： The safe interventional embolismic site is grade 1-3 enteric arterial arch （the near and middle degree） on arch jejuno-ileum hemorrhage and gelfoam grain （diameter 0.5-1 mm） was the safe and appropriate embolismic material.
出处
《武汉大学学报（医学版）》
CAS
2006年第1期108-111,共4页
Medical Journal of Wuhan University
关键词
空回肠出血
放射学
介入
栓塞
治疗
Jejuno-ileum Hemorrhage
Radiology, Interventional
Embolization, Therapy
