闭合性肝外伤超选择性血管造影及栓塞治疗的临床探讨

Application of super-selective hepatic artery angiography and embolization for diagnosis and treatment of non-penetrating hepatic trauma

目的:探讨急诊超选择肝动脉造影及栓塞对闭合性外伤诊断及治疗的价值。方法:28例闭合性肝外伤患者,采用改良Seldinger法经股动脉穿刺置管,超选择肝动脉造影,明胶海绵颗粒等栓塞。结果:经介入栓塞治疗治愈26例,成功率92.86%(26/28)。有2例中转手术治疗(1例并发结肠穿孔,1例并发十二指肠穿孔);共出现并发症2例:其中肝周脓肿1例,肝包膜下血肿破裂出血1例,均行介入治疗治愈(经肝动脉再次栓塞治疗1例,经皮穿刺置管引流1例),所有28例全部治愈。结论:经肝动脉超选择性血管造影及栓塞治疗对闭合性肝脏外伤出血诊断准确,止血效果明显,疗效确切,具有较高临床应用价值。

Objective：To evaluate the diagnosis and treatment value of emergency supe-selective hepatic artery angiography and embolization after non-penetrating hepatic trauma.Method：28patients with non-penetrating hepatic trauma with modified seldinger method of femoral artery puncture,ultra-selective hepatic artery angiography,sent to the hepatic branch artery,and sponge or gelatin sponge particles were used to embolize.Result：26 cases（26 /28,92.86%） of traumatic rupture got hemostasis after intervention,The successful rate was.2cases transferred to operation,including 1case with perforation of colon and 1case with perforation of duodenum.2cases suffered from the complications,including 1case with perihepatic abscess and 1case hepatic hematoma rupture.Among the 2cases,one was cured by the interventional drainage and the other case underwent PTCD.All the cases were cured.Conclusion：The super-selective angiography of hepatic artery and embolization in the treatment of non-penetrating hepatic trauma hemorrhage is a safe and effectivein diagnosis and treatment..