超选择性动脉栓塞治疗肝脾损伤出血

Superselective arterial embolotherapy for hepatic and splenic bleeding due to trauma

目的探讨经导管超选择性动脉栓塞治疗肝脾损伤出血的方法、疗效及安全性。方法本组肝损伤出血7例,脾损伤出血11例,采用股动脉穿刺插管技术,将导管超选择性插管至肝或脾动脉出血分支内,缓慢注射明胶海绵颗粒行栓塞治疗。动脉分支有假性动脉瘤形成者4例,在明胶海绵栓塞治疗后以弹簧圈栓塞出血分支近端。术后密切观察患者生命体征、有无再出血征象及术后反应、并发症发生等情况。结果18例均成功实施超选肝脾动脉分支栓塞治疗,术后患者无再出血发生,病情好转。治疗后患者均无明显不良反应,无严重并发症发生。结论超选择性动脉栓塞治疗肝脾损伤出血是一种安全、易行、有效的治疗方法,可尽量避免外科手术,保留了患者的脏器及功能。

Objective:To investingate the method, efficacy and safety of transcatheter arterial embolotherapy for hepatic and splenic bleeding due to trauma.Methods:Hepatic and splenic bleeding due to trauma were 7 cases and 11 cases respectively. The catheter was introduced into hepatic and splenic bleeding artery branch using the Seldinger technique, and the embolotherapy was performed with gelfoam particles by slow pour. 4 cases artery branch with pseudoaneurysm, the spring coil embolism in the proximal of bleeding artery branch after gelfoam embolization. The patient's vital sign, rehaemorrhagia sign, reaction and complication was observe intimately after procedure.Results:The superselective hepatic and splenic arterial embolotherapy was enforced successfully in 18 cases.The rehaemorrhagia wasn't been found and the patient's condition was improved after procedure. The adverse effect and severity complication was not been found.Conclusion:The superselective arterial embolotherapy for hepatic and splenic bleeding due to trauma is a safe, easy and effective method, as far as possible avoid surgery and reserve the function of organ.