急诊介入造影栓塞对急性动脉性出血的应用价值

Application value of emergency endovascular embolization in acute arterial hemorrhage

目的探讨血管造影及动脉栓塞在急性动脉性出血的应用价值。方法选取2012年1月至2016年4月急性动脉性出血患者29例,通过选择性动脉造影判断有无出血,并明确出血部位,对可进行栓塞治疗者,用明胶海绵、PVA颗粒、弹簧圈、生物蛋白胶等栓塞材料栓塞出血靶血管。结果 22例血管造影表现为造影剂喷射、外溢及浓染,阳性率为75.9%;29例均行栓塞治疗,手术成功率为100%;30次栓塞术后出血症状消失27例,脾梗死1例。结论介入造影栓塞对动脉性出血定位诊断明确,经导管栓塞出血靶血管安全、有效,临床可行性较高。

Objective To investigate the application of DSA diagnosis and interventional embolization therapy in acute arterial hemorrhage. Methods From January 2012 to April 2016,29 patients with acute arterial hemorrhage were selected,by selective angiography was performed to ascertain the bleeding artery,and then gelatin sponge,PVA particles,coils,fibrin glue were chosen to block target vessels. Results Angiography showed contrast agent ejection,overflow and concentrate dye in 22 patients,the positive rate was 75. 9%; Twenty-nine patients underwent interventional embolization therapy,the surgical success rate was 100%; Bleeding stopped immediately in 27 of 30 cases,one patient with splenic infarction. Conclusion DSA is valuable for the diagnosis of various acute arterial bleeding. Interventional embolization therapy is a quick,safe and effective method to control hemorrhage,and should be taken as the first choice.