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经导管动脉栓塞术治疗上消化道出血

Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

作者信息

Širvinskas Audrius, Smolskas Edgaras, Mikelis Kipras, Brimienė Vilma, Brimas Gintautas

机构信息

Department of Interventional Radiology, Republic Vilnius University Hospital, Vilnius, Lithuania.

Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2017 Dec;12(4):385-393. doi: 10.5114/wiitm.2017.72319. Epub 2017 Dec 29.

Abstract

INTRODUCTION

Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment.

AIM

To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality.

MATERIAL AND METHODS

A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization.

RESULTS

The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01).

CONCLUSIONS

In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.

摘要

引言

经导管动脉栓塞术是内镜治疗失败后上消化道复发性出血患者的一种可行治疗方法,也是手术治疗的替代方案。

目的

分析经导管动脉栓塞术的治疗效果,并确定影响发病率和死亡率的临床及技术因素。

材料与方法

基于2013年至2015年在本中心接受经导管动脉栓塞术治疗急性非静脉曲张性上消化道出血的36例患者的数据进行回顾性分析。对早期再出血率、死亡率与以下因素进行分析:患者性别、年龄、输注给患者的浓缩红细胞和浓缩血浆单位数、住院时间、治疗性或预防性栓塞。

结果

栓塞术的技术成功率为100%。有15例(41.70%)治疗性栓塞和21例(58.3%)预防性栓塞。临床成功率为77.8%。栓塞后,10例(27.80%)患者再次出血,9例(25.0%)患者死亡。发现再出血与预防性栓塞之间(OR = 10.53;p = 0.04)、死亡率与预防性栓塞之间(OR = 10.53;p = 0.04)以及浓缩红细胞单位数之间(OR = 1.25;p < 0.01)存在显著关联。

结论

根据我们的经验,经导管动脉栓塞术是治疗急性非静脉曲张性上消化道出血的一种安全治疗方法,对于高危患者可能是手术的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1dc/5776486/27a9bf4f7b8a/WIITM-12-31327-g001.jpg

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