肝破裂修补术后再出血的急诊肝动脉栓塞治疗

Treating hemorrhage of hepatic injury after mending by emergent arterial embolization

目的探讨介入栓塞疗法在肝破裂修补术后再出血中的应用价值。方法8例患者于术后5～18h经保守治疗血流动力学仍不稳定,行血管造影显示肝动脉分支有活动性出血,采用Seldinger技术穿刺,使用明胶海绵和弹簧圈经导管栓塞止血。结果8例患者急诊介入栓塞治疗后出血明显减少,效果明显。结论介入栓塞治疗具有创伤小,见效快,相对简单安全等优点,是肝破裂修补术后再出血的一种有效的治疗手段。

Objective To evaluate the clinical efficacy of emergent hepatic artery embolization for treatment of severe hemorrhage caused by hepatic injury after surgical mending.Methods In 5-18 h after surgical mending,the cardiac hemodynamics of 8 patients were unstable by internal medicine therapy,active bleeding could still be seen in hepatic arterial branch by angiography.Using seldinger technique,hepatic arteries of all patients were embolized with gelatin sponge and spring coils.Results The hemorrhage stopped in 8 patients treated with emergent hepatic arterial embolization.No serious complications related to embolization were encountered.Conclusion Emergent hepatic artery embolization is a safe,easy and effective method for treatment of hemorrhage caused by hepatic injury after surgical mending.