动脉栓塞联合经皮置管引流治疗Ⅲ型腹直肌鞘血肿

Arterial embolization combined with percutaneous catheter drainage for treating type Ⅲ rectus sheath hematoma

目的观察动脉栓塞联合经皮置管引流治疗Ⅲ型腹直肌鞘血肿(RSH)效果及其安全性。方法回顾性分析16例经CT和/或超声证实Ⅲ型RSH并接受动脉栓塞联合经皮置管引流患者资料,分析RSH影像学表现,记录治疗的技术成功率和临床成功率,观察12个月随访期间病变复发状况。结果16例Ⅲ型RSH临床均表现为腹痛,部分伴膀胱刺激症状;其中8例数字减影血管造影显示活动性出血。共栓塞19支出血责任动脉,包括每例1支患侧或血肿较大侧腹壁下动脉及3例外伤侧髂内动脉主干各1支;治疗技术成功率100%,临床成功率87.50%(14/16)。13例接受随访12个月,均未见复发。结论动脉栓塞联合经皮置管引流治疗Ⅲ型RSH效果确切且安全性较高。

Objective To observe the efficacy and safety of arterial embolization combined with percutaneous catheter drainage for treating type Ⅲ rectus sheath hematoma(RSH).Methods Data of 16 patients with type Ⅲ RSH confirmed by CT and/or ultrasound who underwent arterial embolization combined with percutaneous catheter drainage were retrospectively analyzed.The imaging findings of RSH were explored,the technical success rate and clinical success rate were recorded,and the recurrence of RSH during 12 months’follow-up was observed.Results The symptoms of 16 type Ⅲ RSH included abdominal pains and some with bladder irritations.Active hemorrhage was displayed in 8 cases with digital subtract angiography.A total of 19 offending vessels were embolized,including 1 deep inferior epigastric artery at the side with lesion or bigger lesion in each case and 1 more main internal iliac artery on the affected side in 3 cases of type Ⅲ RSH caused by trauma.The technical success rate was 100%,and the clinical success rate was 87.50% (14/16).Thirteen cases underwent 12 months’follow-up,and no recurrence of RSH was found.Conclusion Arterial embolization combined with percutaneous catheter drainage was effective and safety for treating type Ⅲ RSH.