经导管动脉栓塞与Viabahn覆膜支架置入治疗肝胆胰外科术后迟发性出血的对比分析

Comparative analysis of transcatheter arterial embolization and Viabahn covered stent placement in the treatment of delayed hemorrhage after hepatobiliary and pancreatic surgery

目的对比经导管动脉栓塞(TAE)与Viabahn覆膜支架置入(CSP)治疗肝胆胰外科术后迟发性出血(DH-HPS)的疗效及安全性。方法回顾性分析2019年1月至2023年6月徐州医科大学附属医院收治的41例DH-HPS患者的临床资料,其中男性27例,女性14例,年龄(63.1±10.3)岁。22例行TAE治疗者为TAE组,19例行CSP治疗者为CSP组。对比分析两组患者介入治疗效果、血生化指标及并发症情况。结果TAE组止血成功率90.9%(20/22),术后再出血率9.1%(2/22);CSP组止血成功率94.7%(18/19),术后再出血率5.3%(1/19),两组止血成功率、再出血率比较差异无统计学意义(均P>0.05)。术后肝损伤加重率TAE组为100.0%(20/20),CSP组为58.8%(10/17),两组比较差异有统计学意义(χ^(2)=9.77,P=0.002)。37例患者术后随访(18.4±1.7)个月,均无再次出血发生。结论TAE和CSP均是治疗DH-HPS的有效方法,CSP对肝功能的保护作用优于TAE。

ObjectiveTo compare the efficacy and safety of transcatheter arterial embolization(TAE)and Viabahn covered stent placement(CSP)for the treatment of delayed hemorrhage after hepatobiliary and pancreatic surgery(DH-HPS).MethodsThe clinical data of 41 patients with DH-HPS at the Affiliated Hospital of Xuzhou Medical University from January 2019 to June 2023 were retrospectively analyzed.Among these patients,27 were male and 14 were female,with an average age of(63.1±10.3)years.22 patients who underwent TAE was in TAE group and 19 who underwent Viabahn CSP was in CSP group.The interventional treatment effect,blood biochemical indexes and complications were compared between the two groups.ResultsIn the TAE group,the success rate of hemostasis was 90.9%(20/22),and the rebleeding rate was 9.1%(2/22)after interventional treatment.In the CSP group,the success rate of hemostasis was 94.7%(18/19),and the rebleeding rate of was 5.3%(1/19)after interventional treatment.There was no statistically significant difference in the success rate of hemostasis and the rebleeding rate between the two groups(both P>0.05).The rate of liver function exacerbation after the procedure was 100%(20/20)in the TAE group and 58.8%(10/17)in the CSP group,with a statistically significant difference between the two groups(χ^(2)=9.77,P=0.002).37 patients were followed up(18.4±1.7)months,and no rebleeding occurred in all patients.ConclusionTAE and CSP are both effective for DH-HPS,while CSP is superior to TAE in terms of liver function protection.