选择性肝动脉栓塞治疗肝破裂术后再出血的临床价值

Clinical Value of Selective Hepatic Artery Embolization in the Treatment of Rebleeding after Hepatic Rupture

目的:观察选择性肝动脉栓塞术治疗肝破裂术后再出血的临床疗效。方法:我院2008年2月至2013年3月共收治创伤性肝破裂30例,其中28例患者给予肝破裂修补术,术后发生再出血6例,均给予选择性肝动脉栓塞术治疗,观察临床疗效。结果:本组6例患者选择性肝动脉栓塞术均成功,术后观察动脉栓塞造影,显示无对比剂外溢、滞留及聚集现象。术后24h腹腔引流血性液体平均(450±150)mL,48h腹腔引流血性液体平均(50±15)mL,均于72h内腹腔引流干净。术后3d内给予酶谱检测均显示升高,术后7-12d后酶谱均恢复正常。6例患者术后住院14-23d,均痊愈出院,无死亡病例。结论:选择性肝动脉栓塞术治疗肝破裂术后再出血效果理想、安全性高,值得推广应用。

Objective： To observe the clinical efficacy of selective hepatic artery embolization in the treatment of rebleeding after hepatic rupture .Method：30 cases with traumatic rupture of the liver were trea-ted in our hospital from Feb.2008 to Mar.2013 , among them 28 cases were treated with repair of rupture of liver, 6 cases appeared rebleeding after operation , they were all treated with selective hepatic artery emboli-zation for the treatment, clinical effects were observed.Result：6 patients treated with selective hepatic artery embolization were successful , observation of arterial embolism angiography after operation showed no extrava-sation of contrast agent, retention and aggregation.24 hours postoperative abdominal drainage bloody fluid average was （450 ±150 ） mL, 48 hours peritoneal drainage bloody fluid average was （50 ±15 ） mL, in the 72 hours internal drainage of abdominal cavity was clean.The zymogram detection showed increased 3 days after operation, postoperative 7-12 days zymogram was normal.6 patients hospitalized for 14-23d, they were all cured and discharged,and there were no deaths.Conclusion：The effect of selective hepatic artery embolization in the treatment of rebleeding after hepatic rupture is ideal ,it has a high safety ,and it is worthy of popularization and application .