弹簧圈在胰十二指肠切除术后出血治疗中的临床应用

Safety and efficacy of embolization coils for post-pancreaticoduodenectomy hemorrhage interventional therapy

目的探讨弹簧圈在胰十二指肠切除术后出血治疗中的安全性和有效性。方法回顾分析2008年6月至2012年8月北京肿瘤医院22例胰十二指肠切除术后出血使用弹簧圈行介入血管内栓塞治疗的急症患者的临床资料,评价其安全性及有效性。结果 22例患者,其中男性15例,女性7例,年龄27~76岁(平均年龄60.4岁)。其中,5例临床表现为消化道出血,15例为腹腔内出血,2例同时有腹腔内及消化道出血,发生出血时间为术后8 h^72 d,共行27例次介入诊疗。使用弹簧圈行介入栓塞技术成功率92.59%(25/27)。首次栓塞止血成功率81.82%(18/22),两次栓塞止血成功率90.91%(20/22)。2例死亡,1例因腹腔感染反复出血最终栓塞失败死亡,1例栓塞失败死亡。结论对于胰十二指肠切除术后出血的急症患者,在权衡患者风险收益比后,可使用弹簧圈行介入栓塞治疗。

Objective To discuss safety and efficacy of embolization coils for post-pancreaticoduodenectomy hemorrhage interventional therapy.Methods The clinical data about interventional treatment technology and prognosis of 22 patients who were in emergency cases underwent post-pancreaticoduodenectomy bleeding between June 2008 and August 2012 were retrospectively analyzed in Peking University Cancer Hospital.Results In all 22 patients,5 cases underwent gastrointestinal bleeding,15 cases of abdominal bleeding,2 cases had abdominal cavity and gastrointestinal bleeding.Hemorrhage occurred 8 h-72 d after surgery.A total of 27 times interventional procedures were involved.The effective rate of interventional techniques was 92.59%,hemostatic rate of the first interventional procedures was 81.82%.Hemostatic rate of the second interventional procedures was 90.91%.There are 2 patients died,1 patient was repeated hemorrhage because of celiac infection and failed at last,and 1 patient was failed after embolization.Conclusion After to balance the risk-benefit ratio,the embolization therapy is a technique for patients who have post-pancreaticoduodenectomy bleeding in emergency cases.