超声造影引导经皮注射治疗Ⅲ-Ⅳ级肝创伤出血的临床研究  

Percutaneous injection of hemostatic agents under the guidance of contrast-enhanced ultrasound for grade Ⅲ-Ⅳ hepatic trauma

作　　者：李志艳[1] 唐杰[1] 吕发勤[1] 罗渝昆[1] 李俊来[1] 张惠琴[1] 李文秀[1] 

机构地区：[1]解放军总医院超声科,北京100853

出　　处：《中华超声影像学杂志》2009年第1期37-40,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：全军医药卫生科研基金项目（06G108）

摘　　要：目的探讨超声造影引导经皮注射治疗严重肝创伤出血的可行性及临床应用价值。方法本组11例肝创伤患者，超声造影提示肝破裂Ⅲ级5例，Ⅳ级6例。在超声造影引导下对11例肝创伤出血患者进行经皮止血剂（胶）局部注射治疗，并评价该治疗方法的疗效。结果11例严重肝创伤的患者中9例经一次治疗成功；1例患者超声造影发现再出血后，给予第二次止血治疗；1例因腹腔积液增加同时合并胰腺损伤而转行手术治疗。结论超声造影可以显示肝创伤的位置和程度，结合介入超声技术，该止血方法对于单脏器损伤者可以达到完全治愈，而对于合并其他脏器创伤者，在完成肝创伤止血后再进行其他脏器创伤的治疗，可赢得抢救时间。Objective To explore the value of percutaneous injection of hemostatic agents under the guidance of contrast enhanced ultrasound （CEUS） for grade Ⅲ-Ⅳ hepatic trauma patients. Methods Eleven patients with severe hepatic trauma were treated using percutaneous focal injection of hemostatic agents. Five of these patients were hepatic injury of gradeⅢ ,and others were grade Ⅳ according to AAST. Results Out of all patients with severe hepatic trauma, 9 patients were cured by once percutaneous injection of hemostatie agents under the guidance of CELTS, and 1 patient was cured by twice injection, and 1 patient was switched to surgery because of complicated pancreatic injury and the increase of free intraperitoneal fluid. Conclusions CEUS can display the site and severity of liver injury. Combining with interventional technology, injection of hemostatic agents under the guidance of CEUS can save life and avoid to resect organ,and it can win time for treating other compound injury.

关 键 词：超声检查 微气泡 肝/损伤 止血 

分 类 号：R686[医药卫生—骨科学]