血管腔内技术在腹腔脏器急性动脉出血中的应用

目的探讨血管腔内技术在腹腔脏器急性动脉出血中的应用价值。方法对159例次急性消化道或腹腔急性出血的患者行腹腔动脉造影检查,对其中阳性且无治疗禁忌的40例次置入弹簧圈、注入明胶海绵颗粒、放置覆膜支架等方式行腔内止血治疗。通过术后造影、症状、生命体征、实验室检查结果判断止血是否成功。结果 47例次(47/159,29.56%)造影阳性;外科术后出血77例次,造影阳性率37.66%(29/77),非外科术后消化道出血82例次,造影阳性率21.95%(18/82),两者差异有统计学意义(P0.05)。造影阳性患者共进行40例次介入治疗,其中置入弹簧圈33例次,注入明胶海绵颗粒4例次,置入覆膜支架3例次,腔内止血成功率为100%(40/40)。结论血管腔内技术是治疗腹腔脏器急性动脉出血的可靠手段。

Role of endovascular technique in acute arterial hemorrhage of abdominal organs

Objective To investigate the effectiveness of endovascular technique in treatment of acute arterial hemorrhage of abdominal organs. Methods Totally 159 cases (145 patients) acute arterial hemorrhage of abdominal organs were enrolled. All patients underwent emergency transarterial angiography. Endovascular treatment by spring coil, gelatin sponge, or covered stent were in 40 cases. The success rate of immediate and long-term hemostasis was judged by the postoperative radiography, symptoms and the changes of vital signs and laboratory results. Results The positive signs in angiography were observed in 47 among the total 159 cases (47/159, 29.56%). Seventy-seven postoperative hemorrhage cases underwent angiography and 29 cases (29/77, 37.66%) were positive, 82 non-operative hemorrhage cases underwent angiography and 18 cases (18/82, 21.95%) were positive. The difference was statistical significant (P<0.05). Endovascular treatment were performed in 40 cases (33 by spring coils, 4 by gelatin sponge and 3 by covered stent). Hemorrhages were controlled immediately in all the 40 cases after embolization and the success rate were 100%. Conclusion Endovascular technique is minimal invasive, and it is an effective method for treatment of acute arterial hemorrhage in abdominal organs.