选择性动脉造影栓塞在腹部创伤中的应用

Application of arteriographic embolization in abdominal trauma

目的 探讨选择性动脉造影栓塞 (AE)在腹部和骨盆创伤出血的治疗效果。方法 1997～ 2 0 0 3年应用AE治疗腹部创伤病人 ,将其分为三类 :Ⅰ类 2 4例 ,腹部外伤后脏器出血。Ⅱ类 5例 ,腹部外伤手术后出血。Ⅲ类 4例 ,骨盆手术前先作髂内动脉栓塞 ,以预防手术时出血。对治疗和结果作回顾性分析。结果 3 3例病人造影 66处 ,栓塞 41处 ,有效率 97 0 % ,死亡 1例 (3 0 % )系栓塞无效。 2例直接并发症分别为异位栓塞和血管内膜损伤 ,均治愈。结论 AE可减少腹部和骨盆创伤出血 ,手术止血困难、术后出血或预防骨盆手术前出血 ,也是可选择的手段 ;

Objective To evaluate the effect of selective arteriographi c emboli zation (AE) on controlling bleeding after abdominal or pelvic trauma. Meth ods Th irty-three patients underwent AE for abdominal or pelvic trauma from 1997 to 200 3; AE process and the patients outcome were analysed retrospectively. The patie nts were divided into 3 groups: in group one(n=24), AE was nonoperative hemostas is after abdominal trauma; in group two(n=5), AE was done due to postoperative b leeding in abdominal trauma; in group three(n=4), iliac AE was done to prevent hemorr hage before the operation of pelvic fracture. Results In these 33 p atients, arte riography was performed in 66 sites and 41 sites were embolized . Effective rate was 97.0% and only one (3.0%)died from AE failure. Two cases developed complica tions including anomalous embolization and iatrogenic injury of vessel, and both were cured. Conclusion Arteriographic embolization can be effective ly and safely used for controlling bleeding in abdominal and pelvic trauma;it's also recomme nded for difficult hemostasis, postoperative bleeding or for preventing bleeding before pelvic operation. AE is safe for patients with shock.