胶栓塞治疗消化道出血安全有效吗？

Gastrointestinal Intervention Pub Date : 2018-10-31 DOI:10.18528/GII180030

Shinsaku Yata, Y. Ohuchi, A. Adachi, M. Endo, Shohei Takasugi, Kazumichi Tsukamoto, Kensuke Matsumoto, Mika Kodani, J. Makishima, S. Fujii

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引用次数: 3

摘要

与包括明胶海绵、金属线圈和聚乙烯醇（PVA）颗粒在内的传统栓塞材料相比，使用2-氰基丙烯酸正丁酯（NBCA）进行经导管动脉栓塞治疗胃肠道动脉出血能够实现更高的止血率和更低的复发出血率。胶水栓塞对凝血病患者特别有效。即使在下消化道，胶栓塞引起的缺血性肠并发症也与其他药物相当。尽管食管动脉的解剖结构复杂多样，但胶水栓塞对动脉食管出血也很有效，没有任何严重的缺血性并发症。对于胰十二指肠切除术或肝叶切除术等腹部手术后的出血，介入放射科医生应小心指示胶栓塞，因为侧支血管较少容易导致严重的缺血性并发症。改性胶，如Glubran 2（NBCA与甲基丙烯酰氧基富烷相关），由于其较少的热反应，可以降低缺血性并发症的风险，但结果似乎不令人满意。版权所有©2018，胃肠道干预学会。

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Is glue embolization safe and effective for gastrointestinal bleeding?

Transcatheter arterial embolization using N-butyl-2-cyanoacrylate (NBCA) for gastrointestinal arterial bleeding enables higher cessation rate and lower recurrent bleeding rate compared with conventional embolic materials including gelatin sponge, metallic coil, and polyvinyl alcohol (PVA) particle. Glue embolization is particularly effective in patients with coagulopathy. Even in the lower gastrointestinal tract, ischemic bowel complications by glue embolization are comparable to other agents. Glue embolization is also effective for arterial esophageal bleeding without any serious ischemic complications although the anatomy of the esophageal artery is complex and varied. For bleeding after abdominal surgery such as pancreaticoduodenectomy or hepatic lobectomy, interventional radiologists should be careful with indicating glue embolization because the presence of fewer collateral vessels can easily result in serious ischemic complications. Modified glue such as Glubran 2 (NBCA associated with methacryloxyfulfolane) can reduce the risk of ischemic complication due to its less thermal reaction, but the outcomes seem unsatisfactory. Copyright © 2018, Society of Gastrointestinal Intervention.

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来源期刊

Gastrointestinal Intervention

自引率

0.00%

发文量

审稿时长

24 weeks

期刊介绍： IJGII (pISSN 2636-0004, eISSN 2636-0012) was published four times a year on the last day of January, April, July, and October, which has effected from January 1 in 2019. This Journal was first published biannually on June and December, beginning in December 2012 under the title ‘Gastrointestinal Intervention’ (former pISSN 2213-1795, eISSN 2213-1809) and was changed to be published three times a year from 2016. Commencing with the January 2019 issue, the Journal was renamed ‘International Journal of Gastrointestinal Intervention’. As the official journal of the Society of Gastrointestinal Intervention (SGI), International Journal of Gastrointestinal Intervention (IJGII) delivers original, peer-reviewed articles for gastroenterologists, interventional radiologists, surgeons, gastrointestinal oncologists, nurses and technicians who need current and reliable information on the interventional treatment of gastrointestinal and hepatopancreaticobiliary diseases. Regular features also include ‘state-of-the-art’ review articles by leading authorities throughout the world. IJGII will become an international forum for the description and discussion of the various aspects of interventional radiology, endoscopy and minimally invasive surgery.