32例动脉出血性疾病介入治疗疗效分析

Efficacy analysis of 32 cases artery hemorrhagic disease intervention treatment

目的:探讨急性动脉出血性疾病经导管超选择性出血动脉栓塞治疗的临床效果。方法:在DSA下造影,明确出血部位,用明胶海绵、栓塞颗粒、丝线线段、微弹簧圈、弹簧栓子等进行栓塞介入治疗32例患者。结果:32例患者中有30例用明胶海绵或钢圈超选择性栓塞治疗后出血停止,其中1例栓塞治疗后于1个月及2个月后分别再次出血;1例经动脉内灌注垂体后叶素,出血停止;1例造影后发现明显造影剂外渗,但因血管太细及血管成锐角扭曲,微导管无法超选而放弃栓塞治疗,改开放手术。所有被栓塞患者均未出现严重并发症,其中1例栓塞后出现下腹腹痛,经止痛药物保守治疗后症状缓解。结论:选择性动脉插管治疗动脉出血性疾病具有创伤小、止血迅速、术后反应及并发症少、恢复快及操作可重复性等优势,值得临床上广泛推广运用。

Objective： To investigate the value of intervenient arterial transcatheter embolization used in the patients with the acute arterial bleeding： Methods： Seleetived angiography under the DSA, made sure the bleeding sites and emboliza- tion treatment of them with absorbable gelatin sponge, embolization particles, thread segments, micro-coil, wreath of spring embolish in 32 cases. Results： Thirty cases in thirty-two patients of artery bleeding were performed angiography, then treated by arterial embolization with absorbable gelatin sponge or wreath of spring, they stopped bleeding immediately. There was one case in which bleed again in one and two months later; one case among them was intra-arterial infusion of vasopressin, then bleeding stopped. We also found there was existing the extravasation of the contrast agent in one case, but the blood vessels were too small and distorted into an acute angle, we could＇t use micro-catheter embolization, then changed to open surgery. All embolization patients ~lidn＇t have serious complications, only 1 case of them had appeared abdominal pain, and the symptoms was disappeared after conservative treatment. Conclusion： Interventional therapy has the advantages of less trauma, stopping the bleeding quickly, little reaction and fewer complications after the operations, faster recovery and repeatability of operation, it is worth widely using in clinical.