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上消化道和空肠肿瘤的急诊动脉栓塞术:12例严重出血患者的分析

Emergency arterial embolization of upper gastrointestinal and jejunal tumors: An analysis of 12 patients with severe bleeding.

作者信息

Zandrino F, Tettoni S M, Gallesio I, Summa M

机构信息

Department of Radiology, Azienda ospedaliera SS Antonio e Biagio e C. Arrigo, Via Venezia 16, 15137 Alessandria, Italy.

Department of Radiology, Azienda ospedaliera SS Antonio e Biagio e C. Arrigo, Via Venezia 16, 15137 Alessandria, Italy.

出版信息

Diagn Interv Imaging. 2017 Jan;98(1):51-56. doi: 10.1016/j.diii.2016.04.003. Epub 2016 May 10.

Abstract

PURPOSE

The goal of this study was to retrospectively assess the efficacy of emergency percutaneous transcatheter arterial embolization in patients with severe bleeding due to upper gastrointestinal or jejunal tumor.

MATERIALS AND METHODS

Twelve patients (7 men, 5 women; mean age, 74 years±14 (SD); range: 54-86 years) with severe bleeding from the upper gastrointestinal tract, with failed endoscopic treatment not eligible for emergency surgery were treated by emergency percutaneous transcatheter arterial embolization. The bleeding cause was gastric tumor in 7 patients, duodenal tumor in 4 patients and jejunal tumor in one patient. Procedure details and follow-up were reviewed.

RESULTS

Twelve embolization procedures were performed using various embolic agents. Embolization was achieved and bleeding was stopped in all patients. Five patients underwent surgery within the 30 days following embolization. In the remaining 7 patients, no bleeding occurred at 1 month follow-up in 6 patients and bleeding recurred in one patient at 1 month. In this later patient, endoscopic treatment was successful.

CONCLUSION

The results of our study suggest that transcatheter arterial embolization is safe and effective in patients with severe arterial bleeding due to upper gastrointestinal or jejunal tumor. In some patients, transcatheter arterial embolization can be used as a bridge to surgery.

摘要

目的

本研究的目的是回顾性评估急诊经皮经导管动脉栓塞术对上消化道或空肠肿瘤所致严重出血患者的疗效。

材料与方法

12例上消化道严重出血患者(7例男性,5例女性;平均年龄74岁±14(标准差);范围:54 - 86岁),内镜治疗失败且不符合急诊手术条件,接受了急诊经皮经导管动脉栓塞术治疗。出血原因包括7例胃肿瘤、4例十二指肠肿瘤和1例空肠肿瘤。回顾了手术细节及随访情况。

结果

使用多种栓塞剂进行了12次栓塞手术。所有患者均成功实现栓塞并止血。5例患者在栓塞后30天内接受了手术。其余7例患者中,6例在1个月随访时未再出血,1例在1个月时出血复发,该患者内镜治疗成功。

结论

我们的研究结果表明,经导管动脉栓塞术对于上消化道或空肠肿瘤所致严重动脉出血患者是安全有效的。在一些患者中,经导管动脉栓塞术可作为手术的桥梁。

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