创伤性出血的急诊动脉栓塞治疗

Treatment of serious traumatic hemorrhage by emergent arterial embolization

目的探讨创伤性大出血的介入栓塞治疗方法和效果。方法２２例出血中１２例系肝胆系术后出血，１０例系刀刺伤出血，均采用急诊动脉造影确定出血部位和原因。创伤性假性动脉瘤１８例、动静脉瘘４例。弹簧钢圈栓塞７例，明胶海绵栓塞２例，钢圈＋明胶栓塞１３例。结果栓塞治疗后即时止血效果１００％，明胶海绵栓塞１例发生再出血，钢圈或／和明胶海绵栓塞病例均无再出血。结论急诊动脉栓塞是治疗创伤性大出血的理想方法，使病人能避免手术创伤打击。

? Objective To evaluate the methods and cu rative effect of interventional embolization of serious traumatic hemorrhage. Methods 12 of 22 were postoperative of liver and bili ary tracte and another 10 were suffered from stab wounds. All cases accepted eme rgent arterial angiography to search for the bleeding factors and positions. The re were 18 cases embolized with steel coils, 2 with galfoam, 13 with steel coils and gelfoam. Results Bleeding in all patients, was completely co ntr ollend after interventional embolization except one case of the patients (1/2) w ith gelfoan embolization massive bleeding showed recurrent. The patients with steel coils or steel coils with gelfoana didn't have recurrence of blee ding. Conclusions Emergent arterial embolization was proved to be a u sful tool in controlling traumatic massive bleeding, and keeping the patients out fr om surgical operation with a high successful rate.  【