CO2-DSA在小肠出血诊断中的价值

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摘要目的比较CO2-DSA和非离子碘造影剂在诊断小肠出血中的作用。方法选择2015年10月~2017年6月在中国人民解放军海军总医院确诊为小肠出血患者20例分别用CO2和碘造影剂行肠系膜上、肠系膜下动脉造影，并超选择到疑似出血部位的肠系膜上、下动脉3级分支重复造影，采用盲法评价两种造影剂显示消化道出血的阳性率。结果在肠系膜上、下动脉主干造影时，CO2显示7例（7/20），碘造影剂显示9例（9/20），两组比较差异无统计学意义（χ2=0.417，P > 0.05）。在超选择到肠系膜动脉3级分支造影时，CO2-DSA显示20例消化道出血中的19例（95.0%），碘造影剂-DSA显示14例（70.0%），差异有统计学意义（χ2=4.329，P < 0.05）。结论在超选择到接近出血靶动脉造影时，CO2气体在显示小肠出血比常规碘造影剂更具优势。

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	卢伟杨超张嘉诚杨剑杜鹏马军朋张哲蒋富强

关键词 ：消化道出血, 血管造影, 二氧化碳, 碘造影剂

Abstract：Objective To compare the role of CO2-DSA and non-ionic iodine contrast agent in diagnosis of intestinal bleeding. Methods 20 cases of patients with small intestinal bleeding treated in Navy General Hospital of People′s Liberation Army from October 2015 to June 2017 were selected. Superior and inferior mesenteric arteries angiography were performed in 20 patients by use of both CO2 and iodinated contrast agent. Repeated angiography was performed with super-selective catheterization of the third level branches of suspected arteries. The images were evaluated blindly. The positive depicted of bleeding in both CO2 and iodine contrast agents were compared. Results Small intestinal bleeding was demonstrated in 7 cases (7/20) with CO2-DSA, while 9 cases with iodine contrast agent-DSA (9/20), there was no significant difference between the two groups (χ2=0.417, P > 0.05). Small intestinal bleeding was showed in 19 of the 20 cases by CO2-DSA (95.0%), while 14 cases (70.0%) by iodine contrast agents, with statistically significant difference (χ2=4.329, P < 0.05). Conclusion CO2 gas is superior to iodine contrast agent in demonstrating small intestinal bleeding in case of super-selective catheterization near the bleeding arteries.

Key words： Gastrointestinal bleeding Angiography Carbon dioxide Iodine contrast agent

基金资助:北京市民健康培育项目（Z151100003915112）。

引用本文:

卢伟杨超张嘉诚杨剑杜鹏马军朋张哲蒋富强. CO2-DSA在小肠出血诊断中的价值[J]. 中国医药导报, 2018, 15(10): 118-121.
LU Wei YANG Chao ZHANG Jiacheng YANG Jian DU Peng MA Junpeng ZHANG Zhe JIANG Fuqiang. The value of CO2-DSA in the diagnosis of small intestinal bleeding. 中国医药导报, 2018, 15(10): 118-121.

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