经导管栓塞治疗肝脏外伤出血

目的 探讨经导管栓塞治疗肝脏外伤出血的疗效、适应证、并发症等.方法 回顾性分析我院从1996年5月到2006年5月收治肝脏外伤出血患者33例,其中24例行肝动脉造影证实为肝动脉假性动脉瘤形成,再超选择插管至病变部位,根据载瘤动脉受损情况,予明胶海绵和(或)弹簧圈栓塞.结果 24例28枚假性动脉瘤栓塞技术上均一次成功.2例分别在栓塞后48 h、72 h再次出血.再次栓塞后1例康复,1例在第2次栓塞后1周因再出血和严重腹腔感染死亡.发热9例,均与栓塞无直接相关.结论 经导管栓塞治疗肝脏外伤出血安全、迅速、有效.

Transcatheter arterial embolization for traumatic hepatic hemorrhage

Objective To investigate the clinical efficacy,indications and complications of transcatheter arterial embolization for the treatment of traumatic hemorrhage of liver.Methods Retrospectively analyzed 33 cases of traumatic hemorrhage of liver admitted to West China Hospital from May 1996 to May 2006.Twenty-four cases underwent hepatic arterial angiography and were diagnosed as hepatic arterial pseudoaneurysms and followed by superselective embolization of the feeding vessel with gelatin sponge and/or spring coils.Results Embolization was succeeded technically in 28 pseudoaneurysms of 24 cases.Rebleeding occurred in 2 cases and a second embolization was performed with one recovered uneventfully.The other died of rebleeding and severe abdominal infection one week after the second embolization.Fever unrelated to embolization occurred in 9 cases.Conclusion Transcatheter arterial embolization is safe,prompt and effective for the treatment of hemorrhage due to hepatic injury.(J Intervent Radiol,2007,16:226-228)