选择性肝动脉栓塞治疗肝破裂术后再出血的临床价值

目的：观察选择性肝动脉栓塞术治疗肝破裂术后再出血的临床疗效。方法：我院2008年2月至2013年3月共收治创伤性肝破裂30例，其中28例患者给予肝破裂修补术，术后发生再出血6例，均给予选择性肝动脉栓塞术治疗，观察临床疗效。结果：本组6例患者选择性肝动脉栓塞术均成功，术后观察动脉栓塞造影，显示无对比剂外溢、滞留及聚集现象。术后24 h腹腔引流血性液体平均（450±150）mL，48h腹腔引流血性液体平均（50±15）mL，均于72h内腹腔引流干净。术后3d内给予酶谱检测均显示升高，术后7-12d后酶谱均恢复正常。6例患者术后住院14-23d，均痊愈出院，无死亡病例。结论：选择性肝动脉栓塞术治疗肝破裂术后再出血效果理想、安全性高，值得推广应用。

Clinical Value of Selective Hepatic Artery Embolization in the Treatment of Rebleeding after Hepatic Rupture

Objective： To observe the clinical efficacy of selective hepatic artery embolization in the treatment of rebleeding after hepatic rupture .Method：30 cases with traumatic rupture of the liver were trea-ted in our hospital from Feb.2008 to Mar.2013 , among them 28 cases were treated with repair of rupture of liver, 6 cases appeared rebleeding after operation , they were all treated with selective hepatic artery emboli-zation for the treatment, clinical effects were observed.Result：6 patients treated with selective hepatic artery embolization were successful , observation of arterial embolism angiography after operation showed no extrava-sation of contrast agent, retention and aggregation.24 hours postoperative abdominal drainage bloody fluid average was （450 ±150 ） mL, 48 hours peritoneal drainage bloody fluid average was （50 ±15 ） mL, in the 72 hours internal drainage of abdominal cavity was clean.The zymogram detection showed increased 3 days after operation, postoperative 7-12 days zymogram was normal.6 patients hospitalized for 14-23d, they were all cured and discharged,and there were no deaths.Conclusion：The effect of selective hepatic artery embolization in the treatment of rebleeding after hepatic rupture is ideal ,it has a high safety ,and it is worthy of popularization and application .