急诊动脉栓塞术在煤矿工伤急救中的应用

Emergency call arterial embolism skill application in giving first aid treatment to in coal mine injury incurred while working

目的探讨经导管超选择性及选择性动脉栓塞术在煤矿工伤急救中的作用。方法收集我院接收发生煤矿工伤经B超、CT等检查明确出血部位的18例患者,未发现明确出血脏器但临床存在明显大出血征象的3例,术前血压30￣90/0￣60 m m H g(1 m m H g=0.133 kPa),术前、术中、术后均积极给予抗休克等治疗,同时急诊行选择性/超选择性出血动脉栓塞术。结果18例患者全部在入院1 h内插管成功,造影见明显对比剂外溢15例,表现为血管中断2例,未见明显阳性表现1例,出血动脉为肝动脉5例、脾动脉4例、髂内动脉6例、肾动脉2例。术后2 h内患者血压稳定回升,24 h内血压逐步回升至正常水平,术后未发生严重栓塞并发症。结论急诊超选择性动脉栓塞术是一种安全、有效、迅速的急救止血方法,在煤矿工伤的急救中作用显著。

Objective Transcatheter of super-selective and selective embohzation in the coal mine where the role of work-related injuries.Methods I collected the hospital to receive the B-mine injuries, CT,such as checks clear the 18 cases of bleeding site and found no bleeding organ but clearly there is an obvious clinical signs of bleeding the three cases, preoperative 30-90/0-60 mm Hg of blood pressure Before the operation after both positive, such as anti-shock treatment, while emergency selective/super-selective bleeding artery 18 patients in the hospital one hour intubation success,imaging contrast agent apparent spillover of 15 cases,the performance of vascular disruption for two cases, no obvious positive performance of one case of bleeding artery for the hepatic artery five cases, four cases of splenic artery, Iliac artery six cases,two cases of renal artery,after two hours of steady recovery in patients with blood pressure,blood pressure within 24 hours gradually recovered to normal level, after no serious complications embolization.Conclusion Emergency super-selective embolization is a safe and effective method to stop bleeding quickly,which is important and apparent role in the first-aid of mine injuries.