Toyoda H, Nakano S, Kumada T, Takeda I, Sugiyama K, Osada T, Kiriyama S
Department of Gastroenterology, Ogaki Municipal Hospital, Japan.
J Gastroenterol Hepatol. 1996 Mar;11(3):252-8. doi: 10.1111/j.1440-1746.1996.tb00071.x.
We estimated the usefulness of a mixture of N-butyl-2-cyanoacrylate (NBCA) with lipiodol for transcatheter arterial embolization (TAE) used to control massive bleeding from gastric or duodenal ulcer. Thirty patients who had gastric or duodenal ulcers and massive bleeding that was uncontrollable by endoscopic procedures were included in this study. All patients were subjected to TAE (without NBCA in 23 and with NBCA in seven patients). Coils and/or gelfoam were also used. The achievement of haemostasis, occurrence of rebleeding and the time taken for TAE were compared between patients who received TAE without and with NBCA. Eighteen of 23 patients (78.3%) who received TAE without NBCA and six of seven patients (85.7%) who underwent TAE with NBCA achieved complete haemostasis without rebleeding. The time for TAE was significantly shorter in patients who received NBCA compared with those who did not (P = 0.0095). TAE using NBCA or a combination of NBCA and coils achieved a rapid, complete embolization regardless of vascular distribution or arterial diameter. Thus NBCA is considered to be useful as a secondary embolization material in TAE that is urgently conducted to control massive bleeding from gastric or duodenal ulcers.
我们评估了N-丁基-2-氰基丙烯酸酯（NBCA）与碘油的混合物用于经导管动脉栓塞术（TAE）以控制胃或十二指肠溃疡大出血的有效性。本研究纳入了30例患有胃或十二指肠溃疡且内镜检查无法控制大出血的患者。所有患者均接受了TAE（23例未使用NBCA，7例使用NBCA）。同时也使用了弹簧圈和/或明胶海绵。比较了未使用NBCA和使用NBCA进行TAE的患者的止血效果、再出血发生率以及TAE所需时间。未使用NBCA进行TAE的23例患者中有18例（78.3%）、使用NBCA进行TAE的7例患者中有6例（85.7%）实现了完全止血且未再出血。与未使用NBCA的患者相比，使用NBCA的患者TAE所需时间显著更短（P = 0.0095）。无论血管分布或动脉直径如何，使用NBCA或NBCA与弹簧圈的组合进行TAE均能实现快速、完全栓塞。因此，NBCA被认为是在紧急进行的TAE中作为控制胃或十二指肠溃疡大出血的二级栓塞材料是有用的。
