介入選擇性動脈栓塞術治療急性動脈破裂出血

潘彥康 黃 敏 劉裕恒

[提要] 目的 探討介入選擇性動脈栓塞術治療急性動脈破裂出血的價值。方法 研究分析31例臨床資料完整的急性動脈出血,采用介入選擇性動脈栓塞術治療。所栓塞的動脈包括左腎動脈分支3例、右腎動脈分支2例、肝右動脈分支3例、胃動脈分支12例、十二指腸動脈分支4例、右髂內動脈分支5例、左髂內動脈分支2例。結果 1次栓塞后立即止血者26例,5例腎外傷破裂者術后1-2d血尿停止。結論 介入選擇性動脈栓塞術是治療急性動脈破裂出血的有效方法之一。

[關鍵詞] 動脈破裂;栓塞;介入治療

[中圖分類號] R543.5[文獻標識碼] A[文章編號] 1004-8650(2009)06-056-02

Angio-intervention about selective artery embolization treatment for acute rupture of artery

PAN Yan-kang, HUANG Min, LIU Yu-heng

( Department of medical intervention, The center of medical Oncology, The People`s Hospital of Guangxi Zhuang Autonomous Region, Nanning 315700 Guangxi,China)

[Abstract] Objective To evaluate clinical efficacy of Angio-intervention about selective artery embolization treatment for acute rupture of artery. Methods Total 31 patients of acute rupture of artery, who with integrated clinical information, were treated with angio-intervention about selective artery embolization. The selective artery were: left renal artery branches(3 cases), right renal artery branches(2 cases), right hepatic artery branches(3 cases), gastric artery branches(12 cases), duodenal artery branches(4 cases), right internal iliac artery(5 cases), left internal iliac artery(2 cases). Results 26 cases of bleeding were ceased after the first embolization, 5 cases of hematuria (traumatic rupture of kidney) were ceased after the operation 1-2d. Conclusion Angio-intervention about selective artery embolization is one of effective treatments for acute rupture of artery.

[Key words] rupture of artery; embolization; intervention; treatment

動脈破裂出血是臨床最危急疾病之一,傳統的治療方法是以外科手術為主,但由于某些部位的動脈破裂出血或臟器損傷后手術止血難以徹底,或因手術時間過長而可危及患者生命。近年來介入治療術的成熟,以及導管技術的發展和成熟,行超選擇性動脈栓塞術可達到立即止血的目的,及時搶救患者生命。本組有31例急性動脈出血者行介入超選擇性動脈栓塞止血法療效佳良,現報道如下。

1資料與方法

1.1一般資料

本組31例,男25例,女6例,年齡6-65歲,平均34歲。高處墜落引起多發性骨折5例,外傷性腎破裂5例,原發性肝癌破裂大出血1例;胃、十二指腸潰瘍出血17例;其中有急性失血性休克5例;8例系急診立即行動脈造影及栓塞治療,3例系外院手術后仍出血不止而行栓塞治療。

1.2手術方法

應用菲利普H3000血管減影機。經皮股動脈以……