肝动脉分支动脉瘤4例临床报告

目的探讨肝动脉分支的动脉瘤的诊断和处理。方法采用Seldinger技术行肝动脉插管血管造影(DSA,digitalsubtraction angiography)及栓塞(TAE),1例行腹腔镜下肝动脉结扎,另2例行手术治疗的患者中,1例行2次TAE。结果经B超、CT结合DSA诊断为胃十二指肠动脉动脉瘤1例,其余3例均因出血行DSA发现。胃十二指肠动脉动脉瘤患者先采用TAE治疗,胃十二指肠动脉远端栓塞完全,近端可疑有血流,在全气腹条件下完成腹腔镜下肝总动脉结扎。3例患者因出血采用TAE治疗,1例出血停止。另2例分别于7d和31d后出血,1例行TAE治疗后停止,另1例行手术切除和肝右动脉结扎治疗。结论TAE是治疗肝动脉及分支动脉瘤的首选方法。对较大或易出血者可行瘤体切除及肝动脉结扎。

MANAGEMENT OF HEPATIC ARTERY ANEURYSM

Objective To report the successful treatment of hepatic artery aneurysm by endovascular embolization,excision and laparoscopy.Methods With Seldinger's technique,digital subtraction angiography(DSA) of hepatic arteriography were performent on 4 patients.Through percutaneous transcatheter embllization(TAE) approach,steel coils were delivered to occlude the aneurysm in all patients.2 patients were also treated with operative resection.1 patient was also treated by ligated hepatic artery with laparoscopic method.Result Color Doppler,CT and DSA gave the correct diagnoses of hepatic artery aneurysm in preoperative time.4 patients were treated by TAE.2 patients were also treated with operative resection.In 1 patient,blood supply of aneurysm outflow tract was occluded.So,we ligated inflow tract with laparoscopic method.Conclusion Based on these preliminary results,we conclude that TAE and laparoscopic treatment are prospective minimally invasive technique for hepatic artery aneurysm.