数字减影血管造影联合腹腔镜治疗非肿瘤性小肠出血的临床应用
| 作者: |
1魏明丽,
1赵海剑,
2尹刚,
1杨林,
1张晓雨,
1平洪
1 徐州医科大学附属淮安医院胃肠外科，江苏 淮安 223002 2 徐州医科大学附属淮安医院介入科，江苏 淮安 223002 |
| 通讯: |
赵海剑
Email: zhj_cn90@163.co |
| DOI: | 10.3978/j.issn.2095-6959.2020.06.022 |
| 基金: | 江苏省“科教强卫工程”青年医学人才项目(QNRC2016424)；淮安市自然科学研究计划项目(HAB201728)。 |
摘要
目的：探讨数字减影血管造影(digital subtraction angiography，DSA)造影联合腹腔镜手术治疗非肿瘤性小肠出血的临床疗效。方法：回顾性分析2010年1月至2018年12月利用肠系膜血管造影及腹腔镜下亚甲蓝定位，行腹腔镜小肠切除治疗的11例非肿瘤性小肠出血患者的临床资料。结果：11例患者均成功DSA亚甲蓝染色并行腹腔镜下小肠部分切除。术后病理诊断为空肠血管发育不良2例，回肠血管发育不良6例，回肠憩室3例。结论：DSA造影联合腹腔镜手术应用于小肠出血的外科治疗，能够精确切除病灶，具备最小创伤侵袭和最大程度保护小肠、缩小切除范围等优点，利于术后康复。
关键词：
小肠出血；选择性肠系膜动脉造影；腹腔镜检查
Clinical application of laparoscopic surgery combined with digital subtraction angiography in the treatment on non-tumor small intestinal hemorrhage
CorrespondingAuthor: ZHAO Haijian Email: zhj_cn90@163.co
DOI: 10.3978/j.issn.2095-6959.2020.06.022
Foundation: This work was supported by the Key Medical Talent Project of Jiangsu Province (QNRC2016426), and the Natural Science Research Program of Huai’an City (HAB201728), China.
Abstract
Objective: To investigate the clinical effect of laparoscopic surgery combined with digital subtraction angiography (DSA) in the treatment of non-tumor small intestinal hemorrhage. Methods: Data from 11 patients who suffered from non-tumor small intestinal hemorrhage and underwent laparoscopic small bowel segmental resection after selective mesenteric angiography and intra-operative methylene blue injection consecutively from January 2010 to December 2018 were analyzed retrospectively. Results: Eleven patients successfully underwent laparoscopic segmental small bowel resection after intra-operative methylene blue injection. Among these patients, 2 were diagnosed pathologically as Jejunal angiodysplasia, 6 as ileal angiodysplasia, and 3 as ileal diverticulum. Conclusion: The application of laparoscopic surgery combined with DSA on the treatment of non-tumor small intestinal hemorrhage can confirm the focus accurately with minimal invasive and protect of the small intestine maximum extent, reduce the scope of the resection, and speed up the rehabilitation after surgery.
Keywords：
small intestinal hemorrhage; selective mesenteric angiography; laparoscopy