介入治疗急诊出血39例报告

目的：探讨介入治疗在出血急救中的临床价值。方法：本组39例,其中男28例,女11例,年龄16～65岁,平均40岁。本组病例均有不同程度失血性休克现象。介入术前血压为（50～100）mmHg/（20～60）mmHg,所有病例均采用右侧或左侧股动脉穿刺入路,先行DSA检查,找出出血血管,实施栓塞术,闭塞出血动脉。术后注意观察生命体征。结果：支气管扩张出血7例,肺癌出血5例,肝癌破裂出血8例,原因不明消化道出血9例;在10例骨盆骨折病人中,髂内动脉主干出血4例,阴部内动脉出血3例,闭孔动脉出血3例。本组病例经急诊介入治疗后血压逐步回升平稳（90～120）mmHg/（60～90）mmHg,未出现严重的栓塞并发症。结论：介入治疗是治疗内脏出血和盆腔外伤导致闭合性血管损伤出血、进而救治生命的一个快捷、安全、合理的选择。

THE INTERVENTIONAL TREATMENT OF EMERGENCY HEMORRHAGE IN 39 PATIENTS

Objective：To evaluate the clinical application of interventional therapy in emergency hemorrhage.Methods：There were totally 39 cases in this paper（28 male and 11 female,aged from 16 to 65 with the average of 40 years old）.All patients had blood loss shock.The blood pressure was（50～100） mmHg/（20～60） mmHg before interventional therapy.In all cases,right or left femoral arteries were punctured with DSA,responsible blood vessels were found and intravascular embolization was performed.After operation,attention was paid to observe the life physical sign.Results：Hemorrhage was caused by 7 cases of bronchiectasis,5 cases of lung cancer,8 cases of liver cancer,and 9 cases of digestive canal bleeding.In 10 cases with pelvic fracture： bleeding of internal iliac artery trunk 4 cases,internal pudendum artery 3 cases and obturator artery 3 cases.After emergency interventional treatment,blood pressure increased progressively and became stable to（90～120） mmHg/（60～90） mmHg,no serious complication presented.Conclusion：The interventional treatment is a rapid and reasonable selection to cure the hemorrhage caused by visceral disorder and pelvic fracture.