SATE Clinical Research Gastrointestinal Bleeding Treatment

Objective:Evaluation the diagnostic value of super selective arteriography of gastrointestinal bleeding and the clinical curative effect of transcatheter embolization treatment of gastrointestinal bleeding.Materials and methods:1. Analyze retrospectively In77cases of patients with clinical gastrointestinal bleeding(42cases of upper gastrointestinal bleeding and35cases of lower gastrointestinal bleeding). All the77cases of the research have super selective arteriography, the bleeding of56cases were identifided(Upper gastrointestinal bleeding in31cases, the lower in25cases). Compared positive detection rate of the upper and the lower gastrointestinal tract bleeding.2. For27cases of gastrointestinal bleeding positive patients with surgical pathology results (upper digestive tract hemorrhage under12cases,15cases of gastrointestinal bleeding)evaluation the localization and qualitative results of super selective angiography.3. Based with surgical pathology,compare the localization and qualitative results of the upper gastrointestinal bleeding and the lower.4.41in56cases of positive Angiography indications with transcatheter embolization. Compare the hemostatic effect of the upper and lower gastrointestinal bleeding, and follow-up of its immediate bleeding rate, rebleeding rate and postoperative complications.Results:1.56in77cases, bleeding are identified with the super selective arteriography, positive checkout are72.7%(56/77),31cases of upper gastrointestinal bleeding(73.8%,31/42),25cases of lower(71.4%,25/35). the positive check out rate of the lower gastrointestinal bleeding was not less than the upper by statistics analysis,P>0.05.2. In27gastrointestinal bleeding patients with surgical pathologic results, the location coincidence rate of super slective angiography was81.5%(22/27), qualitative coincidence rate was74.1%(20/27),and had no statistical differences compared with pathologic results.3. By comparing with surgical pathology, super selective arteriography of upper gastrointestinal bleeding positioning coincidence rate was83.3%(10/12), qualitative coincidence rate was75.0%(9/12); The lower gastrointestinal bleeding rates was80.0%(12/15) and73.3%(11/15)respectively.the result of the upper and the lower had no statistical differences.4. in56angiographic positive cases41patients with embolism indications.(25cases of upper gastrointestinal bleeding and16cases of lower) of transcatheter embolization.34cases showed immediate hemostasis, immediately stop bleeding rate of82.9%. With upper gastrointestinal hemorrhage group was84.0%(21/25), the lower group was81.3%(13/16). Through statistical analysis, P>0.05, it is concluded that the curative effect of transcatheter embolization of lower gastrointestinal bleeding is not worse than upper. Recurrence of bleeding in3cases(2cases located in gastroduodenal artery,1case was located in the branch of the superior mesenteric artery)with the pseudoaneurysms due to acute pancreatitis. Recurrent hemorrhage rate was8.82%(3/34).5.the observation of postoperative adverse reaction and complications of Transcatheter embolization hemostatic:general abdominal interventional embolization postoperative complication include abdominal pain, mild-to-moderate fever. This study does not appear arrhythmia, bowel necrosis, perforation, serious complications such as ectopic embolism.Concludes:1. the value of the location and qualitative diagnosis of Super selective angiography is higher, is a reliable diagnostic method of gastrointestinal bleeding.2. Transcatheter embolization of the lower gastrointestinal bleeding is as safe and feasible as the upper gastrointestinal bleeding.