医源性动脉出血的介入栓塞治疗

Interventional embolization for the treatment of iatrogenic arterial bleeding

目的探讨介入栓塞治疗医源性动脉出血的临床应用价值。方法回顾性分析我科35例医源性动脉出血、接受介入栓塞治疗患者的临床及影像资料,观察介入栓塞治疗医源性动脉出血的疗效。结果对35例外科术后动脉出血患者均成功进行介入栓塞治疗。5例肠道术后出血DSA示局部血管紊乱,其中3例见少量对比剂外漏进入肠管,给予适量明胶海绵颗粒进行栓塞;余30例DSA均可见对比剂外漏,其中17例伴假性动脉瘤形成,均采用微弹簧圈予以栓塞。随访10～15天,33例出血停止,2例肠道术后出血患者仍有持续性少量便血,进行再次手术止血治疗。所有患者均未发生器官缺血坏死等严重并发症。结论介入栓塞治疗医源性动脉出血具有一定优势;对于外科术后导致动脉出血、尤其是病情危重的患者,采取介入栓塞治疗具有较好的临床应用价值。

Objective To investigate the value of interventional embolization for the treatment of iatrogenic arterial bleeding.Methods The clinical and imaging data of 35 patients of iatrogenic arterial bleeding who underwent interventional treatment were retrospectively analyzed.The efficacy of interventional embolization of iatrogenic arterial bleeding was observed.Results All 35 patients underwent embolization treatment successfully.DSA showed local vascular disorders in 5 intestinal postoperative patients,while small amount of contrast agent leakage into the bowel in 3 patients,and gelatin sponge particles were given to these 5 patients for embolization.DSA showed visible leakage of contrast agents in remaining 30 patients,including 17 with pseudoaneurysm formation,and micro-coils were used for embolization.During the follow-up of 10—15 days,bleeding ceased in 33 patients,while a small amount of blood were still found in intestinal in 2 patients who then underwent operative hemostasis.No organ ischemic necrosis nor other serious complications occurred.Conclusion Interventional embolization treatment of iatrogenic arterial bleeding has certain advantages,and has good clinical value for patients with arterial bleeding after surgery,especially for critically ill patients.