目的:探讨DSA诊断小肠血管畸形的价值。方法:本文分析21例小肠血管畸形患者的临床及DSA特征,其中男性14例,女性7例,所有患者均行肠系膜上、下动脉造影。结果:临床特征:①急性消化道出血为主症状;②常规检查一般为阴性;③血红蛋白含量短期内降至4~6 g/mL。DSA特征:①动静脉瘘;②局部肠壁染色增浓;③局部血管异常增多,结构紊乱。其中12例进行了动脉导丝栓塞,2例栓塞后出血,进行外科手术切除。结论:DSA是诊断血管畸形所致小肠出血的最有效的方法,动脉导丝栓塞是安全,有效的治疗方法,同时为外科手术切除提供的正确部位。
【Abstract】 Objective To evaluate the detection and localization of obscure lower gastrointestinal bleeding by using SPECT/CT and intraoperative endoscopy. Methods Twenty-six cases of patients with obscure lower gastrointestinal bleeding were analyzed retrospectively. Results The positive detection rate of SPECT/CT was 88.5%. All 26 patients (100%) were identified the bleeding source by using intraoperative endoscopy. No recurrence was found during 1-24 months follow-up. Conclusion SPECT/CT examination should be chosen firstly for patients with obscure lower gastrointestinal bleeding in order to localize the bleeding site roughly. Intraoperative endoscopy can localize the bleeding site accurately in patients who undergoes operation.