介入治疗在肝破裂出血中的应用

目的探讨介入治疗法在肝破裂(包括创伤性肝破裂和自发性肝破裂)中的应用。方法12例肝破裂出血患者的介入治疗是采用股动脉穿刺,肝动脉造影,以及靶血管(有活动性出血的血管)栓塞的治疗方法。结果12例造影有9例明确靶血管,3例显示肝表面不规则出血。12例均行栓塞治疗,其中,2例在48h内行两次栓堵。介入治疗后72h内随访观察,出血明显减少,血压趋于稳定。其中,9例痊愈出院,1例死于并发损伤,1例死于并发症,1例死于介入治疗后两周再次出血。结论介入治疗相对于外科手术具有操作简单、快捷、安全且创伤小等优点,是治疗肝破裂出血的一种有效方法。

Interventional treatment of hepatic rupture and hemorrhage

Objective To discuss the interventional treatment of traumatic and spontaneous hepatic rupture and hemorrhage.Methods Interventional treatment was performed by using transfemoral artery puncture,hepatic arteriography and target vessels(having active bleeding)embolization in 12 patients who comprised 10 traumatic and 2 spontaneous hepatic rupture and hemorrhage.Results Hepatic arteriography showed that,9 of 12 patients had definite target blood vessels,while 3 of 12 patients had irregular bleeding on hepatic surface.All 12 cases underwent transcatheter hepatic artery embolization,of whom,2 cases underwent twice embolization within 48 hours.At 12 hours after interventional treatment,follow-up observation demonstrated that.the bleeding volume in all patients was significantly reduced and the blood pressure approached to stability.Transcatheter hepatic artery embolization achieved hemostasis in 9 of 12 patients and then they were healing and discharged but 1 case died of associated injury,1 case died of complication,and 1 case died of rebleeding at two weeks after embolization.Conclusion Compared with surgery,interventional treatment is an effective means for treating hepatic rupture and hemorrhage.