探讨经微导管栓塞灌注治疗动脉性消化道大出血的效果及安全性。

选取2010年1月—2016年12月我院收治的消化道大出血患者21例，行数字减影血管造影（DSA）明确诊断为动脉性消化道出血，对其中17例患者实施了经微导管血管栓塞，4例进行了血管加压素治疗，栓塞材料使用微弹簧钢圈、明胶海绵与PVA颗粒。

21例患者中，发现对比剂外溢的直接出血征象者8例，有间接出血征象者7例，DSA检查阳性率71.4%（15/21）。17例患者实施了血管栓塞治疗，其中13例出血停止，4例出血量减少；4例灌注血管加压素治疗，2例出血量减少，2例无效，总有效率90.5%(19/21)。所有患者未见胃肠道坏死等严重并发症。

经微导管栓塞灌注治疗动脉性消化道大出血安全、有效，具有较大临床应用价值。

To investigate the effect and safety of embolization or infusion therapy by micro-catheter for acute arterial gastrointestinal hemorrhage.

From January 2010 to December 2016, 21 patients with acute gastrointestinal bleeding diagnosed by digital subtraction angiography (DSA) were performed by interventional therapy. 17 patients were treated with super-selective embolization and 4 with infusion of vasopressin by micro-catheter. The embolic material included microcoils, gelatin sponge and PVA particles.

Among the 21 patients, the DSA examination positive rate was 71.4% (15/21). Of the 17 patients who were treated with the implementation of endovascular embolization by micro-catheter, the bleeding was stopped in 13 cases, a reduction of the amount of bleeding was observed in the other 4 cases. Of the 4 patients who received micro-catheter infusion of vasopressin treatment, the amount of bleeding reduced in 2 cases while the other 2 showed no improvement. As such, the total efficiency of both procedures was 90.5% (19/21). All patients showed no serious complications of gastrointestinal necrosis.

The embolization or infusion by micro-catheter offers a safe and effective therapy for patients with refractory gastrointestinal arterial bleeding.