摘要
目的研究经导管肠系膜动脉注射治疗溃疡性结肠炎的效果．方法１９９３／１９９７收住辽宁省人民医院消化病房的活动期溃疡性结肠炎患者１３例．患者入院后次日经股动脉插管至肠系膜上或下动脉，先行全结肠数字减影，确定病变范围及程度，然后经导管向肠系膜下或上动脉缓慢推注甲基强的松龙复合制剂．观察动注后患者的临床症状及体征改变情况．３ｄ后，加用灌肠治疗．记录治疗后１ｗｋ，１，２ｍｏ患者的症状、体征、便常规及肠镜改变情况．并长期随访患者．结果经导管冲击治疗后１ｄ～３ｄ，大部分患者的临床症状迅速改善．１ｗｋ后粘液脓血便情况基本消失．灌肠１ｍｏ～２ｍｏ后，未见复发．粪常规恢复正常．肠镜示原病变消失．随诊１ａ～４ａ，除３例因症状复发再行导管治疗外，余未见复发．结论经导管肠系膜动脉注射治疗溃疡性结肠炎，可迅速控制活动期的临床症状，改善肠粘膜病变．该疗法不仅具有局部药物浓度高，全身副作用少，药物能均匀分布受累肠段毛细血管的特点，而且数字减影可清楚显示病变范围及程度．诊断和治疗一次性完成。
AbstractAIM To study the curative effects of drug injection through intro-arterial catheter on ulcerative colitis.METHODS Thirteen patients were treated on the next day after admission with a catheter entered into the superior or inferior mesenteric artery, through femoral artery. DSA was performed at first and the extent and degree of the diseased part was confirmed. Methylprednisolone was injected into the inferior mesenteric artery slowly. The changes of the patient's clinical symptoms and physical signs were observed 3 days later, and added with enema. The patients' clinical symptoms, physical signs and routine stool examination were recorded at the end of the first week, first month and the second month. Longterm follow-up was made.RESULTS One to three days after “impact treatment” through catheter, the clinical symptoms of most patients were ameliorated and mucoid puris bloody stool disappeared. After enema treatment for one to two months, the clinical symptoms did not recur. Routine stool examination turned normal. Colonoscopy revealed that the lesions disappeared, and only three patients relapsed, and the above treatment was repeated during the follow-up for one to four years.CONCLUSION Drug injection into mesenteric arteries can control clinical symptoms in active stage and ameliorate the lesions of colon mucosa. Drugs can be concentrated at the diseased areas with less systemic side-effects.
