外周介入治疗中应用NBCA/Glubran-2胶的临床经验  

The Applications and Correlated Complications of Peripheral Interventional Operations with NBCA/Glubran-2

作　　者：刘涛[1] 姜在波[1] 李征然[1] 黄明声[1] 钱结胜[1] 李名安[1] 单鸿[1] 朱康顺[1] 庞鹏飞[1] 关守海[1] 周斌[1] 张有用[1] 黄文薮[1] 陈俊伟[1] 

机构地区：[1]中山大学附属第三医院介入血管科,广东510630

出　　处：《当代医学》2010年第29期536-541,共6页Contemporary Medicine

摘　　要：目的探讨在外周介入治疗中应用NBCA/Glubran-2胶的临床经验。方法 112例患者共184处部位应用NBCA/Glubran-2胶栓塞治疗,根据病变性质分为动脉性(外周动脉病变)、静脉性(食道胃底静脉曲张及门静脉)及肝脾穿刺道三类,其中外周动脉病变19例,静脉性93例(胃底静脉曲张80例,门静脉13例),肝脾穿刺道72例。根据病变血流速度及血流量不同,配制NBCA/Glubran-2胶与超液化碘油比例为1:2-1:4,对于血流速度较快、血流量较大者,预先用弹簧圈或球囊阻断部分血流后再行组织胶栓塞。根据并发症的严重程度分为轻度和重度并发症,统计此三类病变介入治疗中并发症的差异。结果三类病变(动脉性、静脉性、穿刺道)栓塞有效率分别为100%(19/19)、92.5%(86/93)、100%(72/72)。并发症总例数为16例(8.7%),其中重度并发症3例,分别为肺栓塞、下肢缺血坏死及肠缺血坏死各1例,轻度并发症13例。三类病变并发症发生率存在统计学差异,由高至低为:动脉性(21.1%)、静脉性(10.8%)、穿刺道(2.8%)。结论在外周病变应用NBCA胶/Glubran-2胶栓塞治疗是一种安全有效的方法,掌握病变的血流特性能提高栓塞治疗的有效率,降低并发症发生率。Objective To investigate the efficacy and complications of N-butyl 2-cyanoacrylate（NBCA）/glubran-2 glue used in peripheral diseases,and introduce the experience of using glue.Methods There were 112 patients with 184 embolization with NBCA/glubran-2 glue.These cases were divided into three categories according to hemodynamics of focus：arterial,vein,and puncture tract,which contains 19 embolization for peripheral arterial disease,80 embolization and 13 embolization for gastrio-fundal varicosity and portal vein respectively,72 embolization for transhepatic or transsplenic puncture tract.The ratio of glue to lipiodol varied from 1：2 to 1：4 according to blood velocity of embolized targets.Coils were used to decrease the blood flow before embolization with NBCA when the blood flow was too fast.The complications were def ined as serious and slight.Results The effective rate of the three categories were 19/19（100%）,86/93（92.5%） and 72/72（100%）,respectively.Procedure-related complications were occured in 16 cases,including serious complication in 3 cases and slight complication in 13 cases.The serious complications presented as pulmonary embolization in 1 case,lower extremity ischemic necrosis in 1 case and intestine ischemic necrosis in 1 case.There were significant difference about the rate of complications among all the 3 categories,they were（from high to low）：arterial（21.1%）,vein（10.8%） and puncture tract（2.8%）.Conclusion NBCA/glubran-2 glue is a safe and effective embolization agent for peripheral vascular diseases.The embolization effects are improved and the procedure-related complications are reduced if blood flow of the lesions being well controlled.

关 键 词：组织粘合剂 血流动力学 栓塞 治疗性 放射学 介入性 

分 类 号：R543[医药卫生—心血管疾病]