急诊动脉介入栓塞术在肝脾破裂救治中的应用

目的：探讨急诊动脉介入栓塞术在肝脾破裂救治中的临床应用价值，为临床治疗策略的制定提供参考。方法对58例肝脾破裂患者采用急诊动脉介入栓塞术进行治疗。记录患者的手术时间、导管造影诊断成功率、血管栓塞的情况、患者术后的存活率以及术后并发症的发生情况。同时通过随访，记录患者后遗症的发生情况。结果58例患者中，55例一次栓塞成功，占94．8％；3例二次栓塞成功，无栓塞失败病例，导管造影诊断成功率为100．0％。31例栓塞动脉为脾动脉，10例为肝动脉，8例为肝右动脉，2例为肝左动脉。平均手术时间为（57．8±15．6） min。所有患者均成功止血，术后患者存活率为100．0％。2例术后并发胆漏，1例并发脾脓肿，术后并发症发生率为5．2％。所有患者术后恢复情况良好，未发生后遗症。结论急诊动脉介入栓塞术治疗肝脾破裂具有良好的临床疗效，可在保留患者肝脏、脾脏的情况下，有效控制出血，稳定患者的病情，提高临床抢救的成功率。

Application of emergency transcatheter arterial embolization on liver and spleen rupture

Objective To investigate the value of emergency transcatheter arterial embolization in the treat-ment of liver and spleen rupture,in order to provide the reference for clinical therapeutic strategies.Methods In our hospital,58 patients with liver and spleen rupture were selected.Operation time,catheter angiography,embolization of success rate,postoperative survival rates and the postoperative complications were recorded.Then follow-up,patients with sequela of occurrence was recorded.Results Embolizations of 55 cases were successful,3 cases accounted for 94.8%,2 were successful, no embolization failed, the success rate of catheter angiography in the diagnosis was 100.0%.31 cases of arterial embolization for splenic artery,10 cases of hepatic artery,8 cases of right hepatic artery, 2 cases of left hepatic artery.The average operation time was （57.8 ±15.6） min.All the patients were successfully hemostatic,postoperative survival rate was 100.0%for patients.2 cases of postoperative biliary leakage,1 cases with splenic abscess,the incidence of postoperative complications was 5.2%.Recovery of all patients was good,without the occurrence of sequelae.Conclusion Rupture has good clinical efficacy of emergency transcatheter arterial emboliza-tion in treatment of liver and spleen,liver,spleen can be retained in the circumstances,the effective control of hemor-rhage,improve the clinical success rate.