臀股急性进行性血肿:动脉造影与栓塞控制

Progressive Hematoma in Buttock and Thigh:Arterial Angiography and Transcatheter Embolization

目的观察各类原因所致臀股急性进行性血肿的动脉造影表现,并探讨经导管选择性动脉栓塞技术控制血肿的临床价值。方法 12例臀股急性进行性血肿,均以Seldinger技术行一侧股动脉穿刺置鞘,分别对血肿所在部位行选择性动脉造影和受累动脉分支的超选择性造影,明确血肿局部细小动脉受损及出血状况,以明胶海绵颗粒或微弹簧圈行超选择性栓塞,最后造影复查。结果造影显示10例血肿局部动脉小分支破损、对比剂弥散外溢,2例血肿局部小动脉中断;8例以明胶海绵颗粒超选择栓塞受损小动脉,另4例以1～2枚微弹簧圈栓塞受损动脉;2例于栓塞术后再行血肿清除术,10例栓塞术后临床观察血肿渐行吸收。结论对于臀股各类原因所致之急性进行性血肿,血肿局部行动脉造影可明确血肿发生的确切原因,明胶海绵颗粒或微弹簧圈栓塞可控制血肿继续发展。

Objective To explore the clinical value of arterial angiography and transcatheter embolization in diagnosis and treatment of progressive hematoma in buttock and thigh. Methods Twelve patients with progressive hematoma in but tock and thigh underwent selective and superselective arterial angiography by Seldinger technique to make clear the cause and position of the hematoma. The embolization with gelfoam particle or microspring coils was performed to halt hematoma. Finally, Selective arterial angiography followed the embolization to assess the curative effect. Results Arterial breakage and contrast media leakage were detected in 10 patients, arterial branch obstruction in 2 patients. The embolization with gelfoam particle was performed in 8 cases, with microspring coils in 4 cases. Conclusion Arterial angiography is effec tive in diagnosis of progressive hematoma. Transcatheter embolization is reliable to halt progressive hematoma in buttock and thigh.