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[放射学在胃肠道出血诊断与治疗中的当前可能性(X线诊断、核医学与介入放射学)]

[Current possibilities in radiology for the diagnosis and therapy of gastrointestinal hemorrhage (roentgen diagnosis, nuclear medicine and interventional radiology)].

作者信息

Brühlmann W F, Coosemans C

机构信息

Institut für Röntgendiagnostik, Stadtspital Triemli, Zürich.

出版信息

Schweiz Rundsch Med Prax. 1990 Apr 10;79(15):448-51.

PMID:2186462
Abstract

Especially in acute gastrointestinal bleeding, conventional x-ray examinations with barium sulfate contrast are obsolete. On the other hand, blood pool scintigraphy and selective angiography are efficient methods to localize bleeding sources that have not been identified by prior endoscopy. In the interval between acute bleeding episodes, only vascular or highly vascularised lesions--as aneurysms, angiomas and leiomyomas--can be demonstrated. In all other lesions, active bleeding during the examination is a prerequisite. Angiography has not only a diagnostic, but also a therapeutic potential. By preoperative hemostasis, the circulatory conditions of the patient can be stabilized and surgery can be performed with a lower mortality risk. In "poor risk" patients, transarterial therapy can replace surgical interventions.

摘要

特别是在急性胃肠道出血的情况下,使用硫酸钡造影剂的传统X线检查已过时。另一方面,血池闪烁扫描和选择性血管造影是定位先前内镜检查未发现的出血源的有效方法。在急性出血发作的间歇期,只有血管性或高度血管化的病变,如动脉瘤、血管瘤和平滑肌瘤,才能被显示出来。对于所有其他病变,检查期间的活动性出血是必要条件。血管造影不仅具有诊断潜力,还具有治疗潜力。通过术前止血,可以稳定患者的循环状况,降低手术死亡率风险。对于“高危”患者,经动脉治疗可以替代手术干预。

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