腹部手术后迟发出血的血管内介入治疗

目的探讨腹部手术后及微创诊疗术后迟发出血患者血管造影表现及血管内介入治疗效果 方法分析2010年7月至2013年5月我科对17例腹部手术后及微创诊疗术后迟发出血患者行血管腔内治疗，所有病例均行手术区超选择插管造影及栓塞治疗。 结果17例患者中血管造影有阳性发现者15例，其中有对比剂外渗者12例，9例可同时可见血管损伤征象，3例只表现血管损伤征象。栓塞治疗后15例出血得到控制，2例效果差，其中1例2天后死亡，1例再次手术。 结论经血管栓塞治疗创伤小，止血及时有效，可及时稳定患者病情，为进一步救治赢得时间。是术后迟发性出血的首选治疗方法。

Interventional therapy of delayed hemmorage in patients after abdominal surgery or minimally invasive treatment

ObjectiveTo explore the angiographic features and therapeutic efficacy of interventional therapy of delayed hemmorage in patients who had underwent abdomen operation or minimally invasive treatment. MethodsRetrospectively analyze clinical material of 17 patients who had recently underwent abdomen surgical operation or minimally invasive treatment. A11 patients were treated with transcatheter arterial embolization.Target artery were embolized by coils and/or spongia gelatinosa particles. ResultAmong 17 patients with delayed hemmorage, positive angiographic findings were seen in 15. Among the 15 patients,12 had the sign of bleeding (contrast extravasation),of which 9 patients with the sign of blood vessel injury, 3 patients with blood vessel injury sign only. Bleedings were controlled in 15 patients after interventional embolization. While in 2 patients ,the results were poor, one dead 2 days after embolization, the other underwent another surgical operation. ConclusionEndovascular interventional embolization can be used as the preferred method of treatment of the delayed hemmorage after abdominal surgery or minimally invasive treatment. By this means, we could contral the bleeding timely and effectively at the cost of little trauma and gain time for further treatment.