Mine Takahiko, Murata S, Nakazawa K, Onozawa S, Ueda T, Miyauchi M, Morita S, Kumita S
Department of Radiology/Center for Advanced Medical Technology, Nippon Medical School, Tokyo.
Acta Radiol. 2013 Oct;54(8):934-8. doi: 10.1177/0284185113484644. Epub 2013 Apr 30.
Although the morbidity of bowel ischemic events after glue embolization has been suggested, a causal relationship between glue and ischemia has not been clearly established.
To evaluate the efficiency and safety of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA-TAE) for upper gastrointestinal hemorrhage (GIH).
Between October 2006 and October 2012, 21 patients with upper GIH underwent NBCA-TAE, and endoscopic data were obtained within 30 days of follow-up. Shock index prior to and immediately after NBCA-TAE were compared to determine changes in hemodynamics. Days to Forrest type III, as assessed by follow-up endoscopy, was used as an indicator of the healing process. Other clinical outcomes included days for starting ingestion and for hospital discharge.
Sixteen gastric and five duodenal ulcers, classified into Forrest type I, were treated. Immediate hemostasis was achieved in all the patients, and no re-bleeding occurred within the follow-up period. Shock index significantly (P < 0.001) improved from before (0.99 ± 0.076) to immediately after NBCA-TAE (0.67 ± 0.038). Sequential mucosal healing processes were observed in all the patients, and the number of days to Forrest type III was 9.6 ± 7.1. The number of days for starting ingestion and hospital discharge was 9.0 ± 4.5 and 15 ± 7.7 days, respectively.
NBCA-TAE is an effective and safe method for the control of nonvariceal upper GIH, in terms of contribution to hemodynamics and healing process of the gastroduodenal mucosa.
尽管有人提出胶水栓塞术后肠道缺血事件的发病率，但胶水与缺血之间的因果关系尚未明确确立。
评估经导管动脉栓塞术使用氰基丙烯酸正丁酯（NBCA-TAE）治疗上消化道出血（GIH）的有效性和安全性。
2006年10月至2012年10月期间，21例上消化道出血患者接受了NBCA-TAE治疗，并在随访30天内获取内镜数据。比较NBCA-TAE术前和术后即刻的休克指数，以确定血流动力学变化。通过随访内镜评估的到达福里斯特III型的天数用作愈合过程的指标。其他临床结果包括开始进食和出院的天数。
治疗了16例胃和5例十二指肠溃疡，均为福里斯特I型。所有患者均实现即刻止血，随访期间无再出血发生。休克指数从术前（0.99±0.076）到NBCA-TAE术后即刻显著改善（P<0.001），降至0.67±0.038。所有患者均观察到黏膜的连续愈合过程，到达福里斯特III型的天数为9.6±7.1天。开始进食和出院的天数分别为9.0±4.5天和15±7.7天。
就对血流动力学和胃十二指肠黏膜愈合过程的作用而言，NBCA-TAE是控制非静脉曲张性上消化道出血的一种有效且安全的方法。
