股动脉穿刺术后腹膜后血肿三例临床分析

Clinical analysis of 3 cases of retroperitoneal hematoma after femoral artery puncture

目的探讨股动脉穿刺术后腹膜后血肿原因及对策。方法回顾分析3例住院患者腹膜后血肿形成原因及治疗效果。结果1例行血管修补术，2例保守治疗，均痊愈出院。结论腹膜后血肿是介入治疗严重周围血管并发症，术中透视指导，轻柔的操作，术后仔细观察以及丰富的经验有利于减少并发症发生。

Objective To investigate the causes of retroperitoneal hematoma after femoral artery puncture and related countermeasures. Methods The clinical data of 3 cases of retroperitoneal hematoma after femoral artery puncture as a procedure for intracoronary stent implantation, coronary angiography, or balloon dilatation of lower extremity artery, aged 70, 75, and 79, were analyzed retrospectively. Results All the 3 patients showed gastro-intestinal symptoms, hypotension, increased heart rate, and anemia. The causes included the puncture point of femoral artery being too high, and bleeding from deep iliac circumflex artery, or abdominal aorta or common iliac artery. They all recovered after angioplasty or conservative treatment. Conclusion Fluoroscopic guidance, gentle handling during operation and meticulous postoperative observation are essential to decrease the rate of complication.