用二氧化碳增强血管造影用于检测结肠分管出血和临床结果
Ryoichi Kitamura1, Takaaki Maruhashi2, Reiko Woodhams3
1Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan. k.ryoichi1108@gmail.com.
二氧化碳 (CO2) 血管造影检测了离子对照介质 (ICM) 血管造影遗漏的活跃分歧出血. 这种方法似乎可以降低患有结肠分管出血的患者的再出血率.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 血管成像 血管成像
背景情况:
- 结肠分管出血是下胃肠道出血的常见原因之一.
- 常规含对比剂 (ICM) 增强血管造影是诊断活跃出血的标准.
- 在ICM血管学检测所有活跃出血源的能力存在局限性.
研究的目的:
- 评估二氧化碳增强血管造影在检测ICM血管造影遗漏的活跃分管出血方面的有效性.
- 评估二氧化碳血管学对临床结果的影响,包括再出血和缺血并发症.
- 确定二氧化碳血管造影在栓塞后确认血液静止的有用性.
主要方法:
- 对经过导管血管造影的结肠分管出血患者进行回顾性队列研究 (2008年8月 - 2023年5月).
- 经过阴性ICM血管造影后接受CO2血管造影或用于栓塞后确认的患者与仅接受ICM血管造影的患者之间的比较.
- 分析出血检测率和临床结果,包括再出血和缺血并发症.
主要成果:
- 在48%的病例中,CO2血管造影检测到ICM血管造影错过的活跃出血.
- 在二氧化碳血管造影组 (6.9%) 的复出血率明显低于ICM血管造影组 (23%).
- 缺血并发症的发生率在两组之间是可比的 (CO2为4.5%,ICM血管造影为7.1%,透气管后动脉栓塞为7.1%).
结论:
- 二氧化碳增强血管造影是有效的检测活跃的分管出血 ICM血管造影无法可视化.
- 二氧化碳血管造影的使用与再次出血率的降低有关.
- 二氧化碳血管造影显示出作为辅助或替代成像模式在管理结肠分管出血的承诺.
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