摘要
目的探讨急诊介入治疗腹部和盆腔动脉大出血的临床应用价值。方法收集腹部和盆腔动脉出血患者67例,其中胃十二指肠动脉分支出血11例,肠系膜上动脉分支出血15例,肠系膜下动脉分支出血6例,肾动脉分支出血12例和髂内动脉分支出血23例。采用Seldinger穿刺技术从股动脉插管,先行靶动脉血管造影明确出血动脉,选用明胶海绵条或颗粒、弹簧圈或微弹簧圈、PVA颗粒或海藻酸钠颗粒行超选择性动脉栓塞,术后密切观察患者生命体征变化,并定期追踪随访。结果 67例中1次性栓塞成功65例,2次栓塞成功1例,1例栓塞后仍有少量出血转行手术治疗。67例止血总成功率98.5%。67例止血中有50例术后随访3个月～2年,平均12个月,未见严重并发症发生及复发。结论介入栓塞治疗腹部和盆腔动脉大出血,具有准确、迅速、安全、有效等优点,对靶血管精确的超选择栓塞是成功的关键。【关键词】腹腔;盆腔;大出血;介入性;
Objective To evaluate the clinical application of interventional therapy in treating massive abdominal and pelvic arterial hemorrhage.Methods Sixty-seven patients with massive abdominal or pelvic arterial hemorrhage were collected for this study.The bleeding sites included gastroduodenal artery（n=11）,superior mesenteric artery（n=15）,inferior mesenteric artery（n=6）,renal artery（n=12） and internal iliac artery branches（n=23）.With Seldinger＇s technique the femoral artery was punctured,which was followed by angiography in order to visualize and to confirm the bleeding arteries,and then by using the gelatin sponge particles,coils or micro-coil,PVA particles or granules of sodium alginate the bleeding arteries were occluded.All the patients were observed closely after the operation,focusing on the vital signs.And follow-up observation and examine were conducted regularly.Results Of the 67 patients,successful embolization with single procedure was obtained in 65,with twice procedures in one.The remaining one patient had to receive surgery as there was still small amounts of bleeding after embolization.The total success rate was 98.5%.Fifty patients were followed up for 3 months to 2 years after the arterial embolization（mean 12 months）,and no severe complications or recurrence occurred.Conclusion Interventional embolization is a safe and effective treatment for massive abdominal and pelvic arterial bleeding.It can precisely and instantly occlude the bleeding arteries.The key point of technical success is the proficient super-selective catheterization skill.
出处
《介入放射学杂志》
CSCD
北大核心
2011年第1期22-24,共3页
Journal of Interventional Radiology
关键词
腹腔
盆腔
大出血
介入性
栓塞
abdominal cavity
pelvic cavity
massive bleeding
intervention
embolization
