摘要
目的评估介入栓塞术治疗重症急性胰腺炎伴假性动脉瘤破裂出血的临床疗效及安全性。方法收集2014年12月~2019年12月我院12例重症急性胰腺炎伴假性动脉瘤患者,其中脾动脉瘤10例(5例瘤体位于脾动脉中段,3例位于脾动脉近段,2例位于脾门),胃网膜右动脉1例和胃左动脉1例。患者均经腹部增强CT及CTA确诊。其中8例采用经弹簧圈分次栓塞假性动脉瘤载瘤动脉远端、近端和瘤腔,余4例栓塞动脉瘤供应动脉远端和近端。术后随访24个月,通过腹部增强CT/CTA检查及术后临床表现评估栓塞疗效。结果12例脾动脉瘤栓塞获得成功,术后未发生严重并发症。3例患者术后出现脾梗死和胸腔积液,2例患者术后出现瘤体侧支血管再通出血转外科手术。10例栓塞成功患者,术后随访24月瘤腔及脾动脉未再通,栓塞良好。结论经股动脉弹簧圈栓塞瘤腔、载瘤动脉远、近端治疗重症急性胰腺炎伴假性动脉瘤破裂出血是安全有效的治疗手段。
Objective To evaluate the safety and clinical efficacy of interventional embolization in the treatment of ruptured pseudoaneurysm.Methods Twelve patients collected in our hospital from December 2014 to December 2019.The locations of these 12 pseudoaneurysms included splenicartery(n=10),right gastroepiploic artery(n=1),left gastric artery(n=1).The lesions were in the middle of the splenic artery(n=5),at the proximal site(n=3)and proximal splenic artery(n=2).All the pseudoaneurysm were confirmed by CTA and CT.The eight pseudoaneurysms were occluded with coils in the distal artery of aneurysms,the aneurismal lumen and the proximal artery sequently.The remaining four pseudoaneurysms were done in the distal and proximal arteries.All patients were followed up for 24 months after interventional embolization.The post-embolization effects were evaluated according to the clinical manifestations and enhanced CT.Results The 12 pseudoaneurysms were successfully occluded with spring coils.No serious complications occurred in the follow-up period.Three patients manifested mild splenic infarction and ascites.Another two case had artery re-canalization and shifted surgical treatment.Ten patients had no occurrence of splenic artery re-canalization and the aneurysms never reshaped.Conclusion Interventional embolization with spring coils is a safe and effective method for severe acute pancreatitis with ruptured pseudoaneurysm.
作者
覃岭
赵微
何峰
吴维宇
汪洋
QIN Ling;ZHAO Wei;HE Feng;WU Weiyu;WANG Yang(Department of Digestive System, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China)
出处
《西部医学》
2021年第7期1005-1009,1015,共6页
Medical Journal of West China
基金
成都医学院第一附属医院课题(CYFY12DL-003)。
关键词
重症急性胰腺炎
假性动脉瘤
介入栓塞
Severe acute pancreatitis
Pseudoaneurysm
Interventional embolization
