介入放射治疗闭合性肝外伤的临床疗效（附32例报告）

Clinical efficacy of interventional treatment in blunt liver trauma （ in 32 cases report）

目的对比外科手术，研究介入放射治疗在闭合性肝外伤诊治中的疗效及优势。方法选择2010年7月-2012年10月收治的闭合性肝外伤患者32例，采用介入放射技术，行超选择性肝动脉造影并血管栓塞治疗。并选取同时期手术治疗肝外伤（AAST分级Ⅱ～Ⅳ级）患者27例，对照分析两组相关的病例资料，并对结果进行t检验分析。结果32例接受超选择肝动脉栓塞的患者，腹腔内出血得到有效控制，治疗效果满意，无再出血，随访3—18个月，平均随访时间为10个月，无失访病例，无严重并发症出现。结论介入治疗与传统手术相比，操作时间短，对患者机体影响小，住院时间短。对于治疗Ⅱ～Ⅳ级的肝外伤患者有良好的疗效，具有止血效果可靠、定位准确、创伤小、安全性高等优点。针对Ⅱ～Ⅳ级肝外伤患者有明显优势。

Objective Compared with surgical operation, to investigate the clinical efficacy and advantages of interventional treatment in blunt liver traum. Methods 32 patients from July 2010 to October 2012, who were di- agnosed as blunt liver trauma, received super selective hepatic artery embolization in Chinese People＇s Liberation Army in 98th Hospital . Another 27 ones received operation at the same time in Peolies＇s Liberation Army 98th （ AAST grade II to IV ）. Retrospective analysis of related cases was presented. The results were analyzed by t test. Results All of 32 patients that received super selective hepatic artery embolization were stanched bleeding success- fully. All patients were followed up for 3 to 18 months, the mean follow-up time was 10 months, with no severe complications occurred or no lost cases. Conclusions Compared with surgical operation, interventional treatment had advantage that included eliable hemostasis, less operation time, minimally invasive and less hospitalization time. Interventional treatment had good effects on blunt liver trauma which were AAST grade Ⅱ to Ⅲ.