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[目的]探讨动脉性上消化道出血患者采用急症介入诊断及治疗价值,同时分析诊断过程中影响的相关因素,从而可为临床患者诊断准确性提供重要信息。[方法]回顾性分析我院2002年1月~2014年12月期间112例动脉性上消化道出血患者临床资料,统计导管于2级动脉、3~4级动脉开口造影时出血阳性例数、临床治疗成功率及不同治疗方法间成功率。[结果]经分析发现,2级动脉出血阳性者24例(21.4%)明显低于3~4级动脉开口处出血阳性者112例(100.0%),差异具有统计学意义(P<0.05)。介入治疗后,患者平均收缩压为(117.10±13.57)mmHg明显高于介入治疗前(92.79±18.57)mmHg,差异具有统计学意义(P<0.05)。经治疗后,Hb为(73.7~156.9)g/L,平均为(120.1±22.5)g/L,治疗前后Hb比较,差异具有统计学意义(P<0.05)。经导管明胶海绵栓塞者90例,技术成功者为84例,占93.0%;临床治疗成功者80例,成功率为89.0%;经导管灌注垂体后叶素者40例,技术成功者为32例,占80.0%;临床治疗成功者为22例,占55.0%;2组技术成功率比较,差异无统计学意义;而2组临床治疗成功率比较,差异具有统计学意义(P<0.05)。经导管灌注垂体后叶素治疗后,18例再出血,采用微导管超选择栓塞治疗,其中14例成功,4例失败。栓塞治疗后,4例患者因酗酒而导致再出血。[结论]临床将急症介入应用于动脉性上消化出血诊断,其可较好地发现患者出血部位,从而可实施针对性止血治疗。
[Objective] To explore the value of emergency intervention diagnosis and treatment in patients with arterial upper gastrointestinal bleeding and to analyze the related factors in the process of diagnosis, so as to provide important information for the diagnosis accuracy of clinical patients. [Methods] The clinical data of 112 patients with arterial upper gastrointestinal bleeding from January 2002 to December 2014 in our hospital were retrospectively analyzed. The number of hemorrhage cases in the second and third-fourth arterial angiography was analyzed. The success rate of clinical treatment and the success rate between different treatment methods. [Results] The results showed that 24 cases (21.4%) with grade 2 arterial hemorrhage were significantly lower than 112 cases (100.0%) with grade 3 ~ 4 hemorrhage. There was a statistically significant difference (P <0.05). The mean systolic blood pressure (117.10 ± 13.57) mmHg after interventional therapy was significantly higher than that before interventional therapy (92.79 ± 18.57) mmHg, the difference was statistically significant (P <0.05). After treatment, Hb was (73.7 ~ 156.9) g / L with an average of (120.1 ± 22.5) g / L, before and after treatment, the difference was statistically significant (P <0.05). 90 cases were treated by catheter gelatin sponge, 84 cases were technical success, accounting for 93.0%; 80 cases were successful in clinical treatment, the success rate was 89.0%; catheterization of pituitrin in 40 cases, the successful technique was 32 cases , Accounting for 80.0%. The clinical success rate was 22 cases (55.0%). There was no significant difference in technical success rate between the two groups. The difference between the two groups was statistically significant (P <0.05). After transcatheter infusion of pituitrin, 18 patients underwent re-bleeding and were treated with microcatheter superselective embolization, of which 14 were successful and 4 failed. After embolization, 4 patients had rebleeding due to alcohol abuse. [Conclusion] The clinical application of acute intervention in the diagnosis of arterial upper gastrointestinal bleeding, which can better identify the bleeding site, which can be targeted bleeding therapy.