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目的探讨血管内栓塞治疗消化道机械吻合术后吻合口出血的疗效和安全性。方法 28例经DSA检查证实消化道机械吻合术后吻合口出血患者,超选至病变责任供血动脉,采用血管内明胶海绵和/或弹簧圈栓塞治疗,观察其疗效并总结治疗经验。结果术中造影发现28例出血部位均位于机械吻合口处,并可见对比剂明显外溢,对其责任供血动脉进行超选并栓塞,术后患者腹腔留置引流管出血停止,实验室检查提示血红蛋白及红细胞计数未再下降。术中、术后均未出现与血管内治疗相关的并发症。结论急诊血管内栓塞治疗是消化道机械吻合术后吻合口出血安全、有效的治疗手段。
Objective To investigate the efficacy and safety of endovascular embolization in treating anastomotic bleeding after mechanical anastomosis of digestive tract. Methods Twenty - eight patients with anastomotic bleeding after mechanical anastomosis of gastrointestinal tract were confirmed by DSA. The vessels of responsibility were surgically selected for elective anastomosis. The vessels were treated with endovascular gelatin sponge and / or coil embolization. The curative effect was observed and the treatment experience was summarized. Results Intraoperative angiography found 28 cases of bleeding were located at the mechanical anastomosis, and the apparent contrast agent spilled, the responsibility of the donor artery for superselective and embolization, postoperative abdominal bleeding in patients with cessation of bleeding, laboratory tests suggest that hemoglobin and Red blood cell count no further decline. No intraoperative and postoperative complications associated with endovascular treatment. Conclusion Emergency endovascular embolization is a safe and effective treatment for anastomotic bleeding after mechanical anastomosis of digestive tract.