超选择性动脉栓塞术在急性动脉性大出血治疗中的应用

目的探讨超选择动脉栓塞术在急性动脉性大出血治疗中的应用价值。 方法回顾性分析23例急性动脉性大出血患者的临床资料，全部病例经内科保守治疗无法有效控制出血，对出血部位行选择性DSA，明确出血动脉后行超选择性插管术及栓塞治疗，栓塞材料为明胶海绵颗粒或条。 结果所有病例DSA均显示出血阳性征象，表现为对比剂外溢、血管增粗、扭曲等。栓塞术后21例出血立即停止，1例宫颈癌大出血患者10 h后再次出现大出血，遂行第二次栓塞术，效果满意。1例咯血患者不完全止血，术后配合内科积极治疗后出血停止。病例均无严重并发症。 结论DSA对诊断急性出血有较高价值，超选择性动脉栓塞术能迅速、有效止血，且并发症少，可作为急性动脉性大出血治疗的主要方法。

Application of superselective arterial embolization in treatment of acute arterial hemorrhage

ObjectiveTo explore the application value of superselective arterial embolization in treatment of massive acute arterial hemorrhage. MethodsClinical data of 23 patients with acute arterial hemorrhage were analyzed retrospectively. The bleeding could not been controlled effectively in all patients with conservative treatment, underwent selective DSA and transcatheter arterial embolization with gelfoam particles (strips). ResultsDSA in all cases showed positive signs of bleeding, represented by contrast extravasation, vascular thickening, distortion, etc. Bleeding were stopped immediately after embolization in 21 cases. One case with cervical cancer had bleeding again after 10 h, thus had second embolization and had a satisfied result. One case with hemoptysis did not completely stop the bleeding, after active treatment with medicine bleeding was stopped. All patients had no serious complications. ConclusionsDSA has high valuable in diagnosis of massive acute arterial hemorrhage. Superselective arterial embolization can quickly and effectively stop bleeding with fewer complications, could be used as the primary method in treatment of acute arterial hemorrhage.