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目的观察不明原因消化道出血(OGIB)应用数字减影血管造影(DSA)诊断及介入治疗的临床效果。方法选取医院收治的OGIB患者117例,按照介入治疗方式不同分为观察组(72例)行血管内栓塞术治疗,对照组(45例)行药物灌注治疗。记录DSA诊断阳性率;比较2种介入方式临床疗效、不良反应及随访6个月内复发率。结果 117例患者中,DSA检查显示,直接征象54例,间接征象47例,诊断阳性率为86.3%(101/117);观察组总有效率为94.4%,显著高于对照组的77.8%(P<0.01);观察组不良反应率为13.9%,对照组为13.3%,2组差异无统计学意义(P>0.05);随访6个月内,观察组复发率为4.2%,低于对照组的15.6%(P<0.05)。结论 DSA检查应用于OGIB具有较高诊断价值,且介入治疗采用栓塞术更能迅速止血,降低复发率,疗效切实,且安全可靠,值得临床深入研究。
Objective To observe the clinical effect of digital subtraction angiography (DSA) diagnosis and interventional therapy in patients with unexplained gastrointestinal bleeding (OGIB). Methods A total of 117 OGIB patients admitted to hospital were enrolled in this study. The patients in the observation group (72 cases) were treated with endovascular embolization and the control group (45 cases) with drug infusion. The positive rate of DSA diagnosis was recorded. The clinical efficacy, adverse reactions and relapse rate within 6 months after the two interventions were compared. Results Among 117 patients, DSA showed 54 cases of direct signs and 47 cases of indirect signs. The positive rate of diagnosis was 86.3% (101/117). The total effective rate was 94.4% in observation group, which was significantly higher than that in control group (77.8% P <0.01). Adverse reaction rate was 13.9% in the observation group and 13.3% in the control group. There was no significant difference between the two groups (P> 0.05). Within 6 months of follow-up, the recurrence rate was 4.2% Group 15.6% (P <0.05). Conclusions The DSA examination has a high diagnostic value for OGIB. The interventional treatment with embolization can stop the bleeding more quickly and reduce the recurrence rate. The curative effect is reliable, and it deserves clinical study.