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金属夹在接受不可控内镜治疗的非静脉曲张性上消化道出血患者经导管血管内栓塞中的作用:一项回顾性队列研究。

The role of metallic clips in transcatheter intravascular embolization for non-variceal upper gastrointestinal bleeding cases receiving unmanageable endoscopic therapy: A retrospective cohort study.

机构信息

Department of Gastroenterology, Affiliated Huangyan Hospital of Wenzhou Medical University, Taizhou No 1 People's Hospital, Huangyan, 318020, Zhejiang province, China.

Department of Intervention, Affiliated Huangyan Hospital of Wenzhou Medical University, Taizhou No 1 People's Hospital, Huangyan, 318020, China.

出版信息

Int J Surg. 2018 Oct;58:26-30. doi: 10.1016/j.ijsu.2018.08.006. Epub 2018 Aug 23.

Abstract

INTRODUCTION

This study aims to explore whether metallic clips could be a kind of localizer and guider in transcatheter arterial embolization for patients with non-variceal upper gastrointestinal bleeding, who received an unmanageable endoscopic therapy.

METHODS

A total of 18 patients with non-variceal hemorrhage of the upper gastrointestinal tract, who received an unmanageable endoscopic therapy at *** Hospital of **** Province from July 2010 to December 2016, were included into this study. One or two metallic clips were placed on the margin of the bleeding point to be a mark during the endoscopic therapy. Then, all patients were immediately transferred to have an emergent upper gastrointestinal angiography. Bleeding vessels were embolized when found according to the guidance of the metallic clips. After the procedure, any changes of the patient's condition were closely observed and recorded.

RESULTS

The average transcatheter arterial embolization therapy time was 31 min, 17 patients immediately had a successful result, and the success rate of the arterial embolization therapy was 94.44%. However, the bleeding could not be stopped in one patient. This patient was transferred and underwent a surgical operation to stop the bleeding.

CONCLUSION

Metallic clips could play an important role in accurately locating the bleeding vessel during the trans catheter arterial embolization therapy. Furthermore, it could also improve the success rate of stopping the bleeding during intravascular embolization therapy, and shorten the time of intravascular embolization therapy.

摘要

简介

本研究旨在探讨金属夹是否可以作为一种定位器和引导器,用于经导管动脉栓塞治疗内镜治疗不可控制的非静脉曲张性上消化道出血患者。

方法

本研究共纳入 2010 年 7 月至 2016 年 12 月在*医院接受内镜治疗不可控制的非静脉曲张性上消化道出血的 18 例患者。在进行内镜治疗时,在出血点边缘放置一个或两个金属夹作为标记。然后,所有患者立即进行紧急上消化道血管造影。根据金属夹的引导,发现出血血管后进行栓塞。术后密切观察并记录患者病情变化。

结果

平均经导管动脉栓塞治疗时间为 31 分钟,17 例患者即刻获得成功,动脉栓塞治疗成功率为 94.44%。然而,有 1 例患者的出血无法止住。该患者被转至外科手术以止血。

结论

金属夹在经导管动脉栓塞治疗中可以准确地定位出血血管,提高血管内栓塞治疗止血的成功率,并缩短血管内栓塞治疗的时间。

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