经皮软组织和经皮经血管双介入治疗血管间软组织异物损伤  

Double extra-and endo-vascular interventional treatment of soft-tissue injuries with radiopaque foreign body among vessels

作　　者：杨秀军[1] 邢光富 李巍[1] 史常文 

机构地区：[1]上海市第八人民医院放射科,上海200235 [2]上海市第八人民医院普外科,上海200235

出　　处：《中国介入影像与治疗学》2012年第2期75-78,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：上海市卫生局科研基金(2008186);江苏大学医学临床科技发展基金(JLY2010059)

摘　　要：目的探讨经皮软组织和经皮经血管双介入治疗大血管间软组织异物的可行性。方法对6例经CTA确诊的大血管间金属异物(1例合并创伤性假性动脉瘤)进行双介入治疗。局麻后于电视透视导向下经皮经腔定位异物旁血管后,经皮软组织介入钳取异物。结果异物位于大腿上部3枚、肘窝1枚、前臂2枚,长径3～10mm、短径1～2mm,与毗邻大血管间距0～2mm。成功取出所有异物,术中总透视时间5～9min、总出血量5～10ml,对较小动脉瘤未予治疗,均无严重并发症发生。结论经皮软组织和经皮经血管双介入治疗血管间软组织异物技术可行,为伴血管损伤的血管间软组织异物损伤患者的一站式微创治疗提供了新思路。Objective To observe the efficiency and safety of a new minimally invasive technique of double extra-and endo-vascular interventional treatment（DIT） in treating complicated foreign body（FB） soft tissue injuries.Methods Six patients who had small metal FB embedded in the soft tissue among large vessels proved with CT angiography and 3D imaging underwent DIT,1 of them complicated with a small traumatic pseudoaneurysm.DIT was performed under local anaesthesia and combined percutaneous transluminal vascular positioning and percutaneous soft tissue FB removal.Results Three FBs were in thigh,1 in elbow and 2 in forearm.The intervals from vessels were 0 to 2 mm.All the 6 small metal FBs were removed successfully in the 6 patients.The longest dimension of FBs ranged from 3 mm to 10 mm and the shortest dimension from 1 mm to 2 mm.The overall fluoroscopy time was 5 min to 9 min,and the overall bleeding volume was 5 ml to 10 ml.The pseudoaneurysm was not further treated due to its small size and deep position.No major complication occurred.Conclusion The new fluoroscopy-guided double percutaneous soft-tissue and vascular intervention is feasible and safe for FB removal among large vessels in soft tissues,which may bring new ideal to develop a one-stop minimally invasive method to treat soft-tissue injuries by radiopaque FB.

关 键 词：异物 软组织损伤 放射学 介入性 血管造影术 成像 三维 

分 类 号：R654.3[医药卫生—外科学]