超选择性栓塞脾出血动脉在脾损伤中的应用

Superselective arterial of splenic bleeding embolotherapy in the treatment of traumatic splenic rupture

目的:探讨超选择性栓塞脾出血动脉在脾脏破裂出血中的应用效果。方法:用Seldinger技术穿刺侧股动脉,将导管放至脾动脉主干后造影,显示脾脏出血部位,再将导管超选择放至出血(叶、段)血管,注入聚乙烯醇(PVA)、明胶海绵颗粒栓塞剂进行止血。结果:12例脾动脉造影显示脾外伤(夏氏分级)Ⅱ级5例,Ⅲ级5例,Ⅳ级2例。12例患者均1次栓塞成功,其中脾叶动脉血管栓塞3例,脾段动脉血管栓塞9例。术后无再出血、严重感染及其他并发症发生。结论:超选择性栓塞脾出血动脉是治疗外伤性脾破裂出血的一种有效、易行、安全、微创的方法。

Objective：To evaluate the hemostatic efficac of superselective arterial of splenic bleeding em- bolotherapy in the treatment of traumatic splenic rupture. Methods ： With Seldinger technique, a catheter was in- troduced into the splenic artery via the femoral artery for angiography.Once the bleeding sites were identified, catheters were placed into the hemorrhagic vessels to control the bleeding with PVA or gelatin sponge. Results： The angiography of the spleen who are 12 patients showed grade 11 splenic rupture （Xia＇s classification） in 5 pa- tients,grade 111 in 5,and grade IV in 2.The surgery was completed in the first attempt in all the 12 cases. In the patients,embolizations of the lobar and segmental arteries were performed on 3 and 9 cases respectively. There were no one had hemorrhage,serious infection or other complications after surgery. Conclusions： Superselective arterial of splennic bleeding embolotherapy is an effective, simple and minimally invasive therapy for patients with traumatic solenic rupture.