Kết quả sớm trong điều trị xuất huyết tiêu hóa không do tăng áp lực tĩnh mạch cửa bằng can thiệp nội mạch tại Bệnh viện Chợ Rẫy

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Tác giả: Tấn Phát Hồ, Thị Ngọc Hân Lê, Văn Khoa Lê, Công Minh Nguyễn, Huỳnh Nhật Tuấn Nguyễn, Văn Tiến Bảo Nguyễn, Văn Việt Thành Nguyễn, Đăng Tú Phạm, Thy Thiên Phạm, Văn Khiêm Phạm, Phùng Dũng Tiến Trần, Minh Giảng Trương, Thế Hiệp Trương, Minh Ngọc Vũ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.188

Bộ sưu tập: Metadata

ID: 339217

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- Mục tiêu nghiên cứu: Đánh giá hiệu quả và tính an toàn của kỹ thuật can thiệp nút mạch trong điều trị xuất huyết tiêu hóa không do tăng áp lực tĩnh mạch cửa.- Phương pháp: Nghiên cứu hồi cứu mô tả hàng loạt trường hợp các bệnh nhân bị xuất huyết tiêu hóa nhập viện tại bệnh viện Chợ Rẫy trong thời gian từ 2020 đến 2022- Kết quả: Nghiên cứu thực hiện trên 34 bệnh nhân (82% nam, 18% nữ
tuổi trung bình là 52). Kết quả nghiên cứu bao gồm vị trí mạch tổn thương, thành công kỹ thuật, các biến chứng sau phẫu thuật. Thành công kỹ thuật trong nghiên cứu là 100%. Đa số bệnh nhân có hình ảnh thoát mạch trên DSA (53%), vị trí mạch máu tổn thương ở động mạch vị tá tràng và nhánh hồi tràng là thường gặp nhất chiếm tỷ lệ 26.5% với loét dạ dày tá tràng là nguyên nhân thường gặp nhất (23,5%). Nghiên cứu cho thấy XHTH trên và nút mạch không hoàn toàn là các yếu tố ảnh hưởng đến diễn tiến nặng sau can thiệp. Xuất huyết tái phát có thể đã xảy ra 5 trường hợp diễn tiến nặng trong thời gian theo dõi- Kết luận: Can thiệp nội mạch trong điều trị xuất huyết tiêu hóa ít xâm lấn, biến chứng, có tỉ lệ thành công cao. Vì vậy, đây là một thủ thuật an toàn, nhất là cho nhóm bệnh nhân lớn tuổi, có nhiều bệnh nền kết hợp đi kèm.Abstract- Objective: To evaluate the efficacy and safety of embolization techniques in the treatment of non - variceal gastrointestinal bleeding - Methods: A retrospective cases series of patients with gastrointestinal bleeding admitted to Cho Ray hospital during the period from 2020 to 2022. - Results: The study was carried out on 34 patients (82% male, 18% female
mean age 52). The results of the study included the location of the damaged vessels, the technical success, and the complications after surgery. The technical success in the study was 100%. Most patients have peptic ulcer (23.5%), and extravasation on DSA (53%), vascular lesions in gastroduodenal artery and ileal branch are the most common (accounting for 26.5%). The study showed that the upper GI bleeding and incomplete embolization are the factors affecting the progression of severity after intervention.Recurrent bleeding have occurred in 5 cases during follow - up - Conclusion: Endovascular intervention in the treatment of gastrointestinal bleeding is minimally invasive and complicated, with a high success rate. Therefore, this is a safe procedure, especially for elderly patients with many comorbidities. DOI: 10.59715/pntjmp.2.1.23

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