Rosenkrantz H, Bookstein J J, Rosen R J, Goff W B, Healy J F
Radiology. 1982 Jan;142(1):47-51. doi: 10.1148/radiology.142.1.6975953.
From a total of 23 cases from five hospitals, acute colonic mucosal necrosis developed in three patients following transcatheter embolotherapy for colonic hemorrhage. Although embolic therapy for lower gastrointestinal bleeding is associated with appreciable risk, these risks are less than those of emergency operation for hemorrhage. The alternative transcatheter therapeutic modality, vasopressin infusion, is often associated with continued or recurrent hemorrhage, is relatively contraindicated in patients with coronary disease, and produces numerous complications. Transcatheter embolotherapy is recommended for patients with colonic bleeding who have a contraindication to vasopressin administration, who are refractory to vasopressin, or who rebleed following treatment with vasopressin.
在来自五家医院的总共23例病例中,3例患者在经导管栓塞治疗结肠出血后发生了急性结肠黏膜坏死。尽管经导管栓塞治疗下消化道出血存在相当大的风险,但这些风险低于出血急诊手术的风险。另一种经导管治疗方式,即血管加压素输注,常常伴有持续出血或再出血,在冠心病患者中相对禁忌使用,并且会产生许多并发症。对于有血管加压素给药禁忌证、对血管加压素治疗无效或在血管加压素治疗后再出血的结肠出血患者,推荐行经导管栓塞治疗。