野战微创介入方舱内实施对脾脏损伤的快速救治实验  

Treatment of Splenic Injury in Minimally Invasive Intervention Mobile Cab

作　　者：姚天明[1,2] 孙景阳[2] 梁明[2] 王耿[2] 梁卓[2] 霍煜[2] 韩雅玲[2] 

机构地区：[1]辽宁中医药大学,辽宁沈阳110032 [2]沈阳军区总医院,辽宁沈阳110016

出　　处：《现代生物医学进展》2012年第7期1270-1273,1400,共5页Progress in Modern Biomedicine

基　　金：全军"十一五"重大专项课题(08Z0001)

摘　　要：目的:探讨在战争或自然灾害等野战特定条件下,使用野战微创介入方舱,现场对脾脏创伤实施快速微创介入栓塞救治的可行性及效果,形成介入方舱内对脾脏进行快速介入栓塞救治的流程。方法:野战条件下,展开野战介入方舱,在血管造影机下对大动物(狗)脾动脉进行血管内穿刺造模,建立脾动脉损伤模型,按照方舱内快速微创介入救治的流程,对脾动脉受损伤的动物(狗)实施腹部内受损脾动脉的栓塞止血术式。结果:按照设定的预案,对脾损伤的模型动物实施早期介入栓塞脾动脉止血治疗,全部实验动物2周存活率为100%。结论:野战条件下,考虑到转运风险时或者伤情十分紧急时,靠近事发现场展开野战微创介入方舱,对腹部脾脏损伤开展紧急介入栓塞止血救治,不仅可为病人后续的治疗争取宝贵时间,大幅降低一线伤死率,而且脾脏的保全也提高伤员愈后的生活质量。Objective： This study aimed to evaluate the feasibility and effectiveness of on-spot emergent transcatheter arterial embolization（TAE） for splenic injury in the novel miniature mobile cardiac catheterization laboratory（Mini Mobile Cath Lab） following natural disasters or during wartime,and to establish the flow chart for the swift TAE treatment of splenic injury.Method： The Mini Mobile Cath Lab was deployed under wartime condition.The splenic artery injury model was induced by intravascular puncture of splenic artery in large animals（dogs） under the guidance of angiography.Following the flow chart for the Mobile Cath Lab-based swift minimally-invasive interventional therapy,inter-abdomen interventional embolization procedure for the injured splenic artery was performed in an animal model of dog.Results： According to designated plan,animals with splenic injury were treated with emergent TAE,which achieved a 2-week survival rate of 100%.Conclusions： During time of war,the deployment of the Mini Mobile Cath Lab close to the spot of emergency for immediate TAE treatment of splenic injury is safe and effective in consideration of transfer-related risk or emergent traumatic condition,which can save valuable time for the subsequent treatment and reduce the death rate.Meanwhile,the preservation of spleen can also improve the patients＇ quality of life after fully recover from the injury.

关 键 词：微创介入 脾损伤 栓塞 

分 类 号：R657.62[医药卫生—外科学] R459.7[医药卫生—临床医学]