胰十二指肠术后出血的血管造影表现及介入治疗  

Angiographic findings and interventional theraphy for post-pancreaticoduodenectomy hemorrhage

作　　者：徐海峰[1] 朱旭[1] 陈辉[1] 王晓东[1] 曹广[1] 刘鹏[1] 高嵩[1] 郭建海[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所介入治疗科,恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华医学杂志》2013年第1期55-57,共3页National Medical Journal of China

摘　　要：目的探讨胰十二指肠术后出血的血管造影表现及介入治疗的安全性和疗效。方法回顾分析2009年8月至2012年6月北京肿瘤医院介入科29例胰十二指肠术后出血行介入治疗患者的临床资料、血管造影表现、介入治疗技术和预后。结果29例中，6例为消化道出血，21例为腹腔内出血，2例同时有腹腔内及消化道出血，出血时间为术后8h～72d。血管造影表现为造影剂外渗、假性动脉瘤形成、动脉管壁不光整、局限性狭窄、远端动脉扩张。介入治疗技术成功率93．94％，止血成功率89．66％。3例死亡。结论介入栓塞治疗是安全有效的技术，应为胰十二指肠术后出血患者的首选治疗。Objective To discuss the angiographic findings and the safety and efficacy of interventional therapy for post-pancreaticoduodenectomy hemorrhage. Methods The clinical data, features of angiography, interventional treatment technology and prognosis of 29 patients underwent post- panereaticoduodenectomy bleeding between August 2009 and June 2012 were retrospectively analyzed in our hospital. Results In all 29 patients, 6 cases underwent gastrointestinal bleeding, 21 cases of abdominal bleeding, 2 eases had abdominal cavity and gastrointestinal bleeding, hemorrhage occured 8 h-72 d after surgery. Angiographie findings including： extravasation of contrast media, and pseudo aneurysm formation, local arterial intima not smooth, stenosis, distal artery branch expansion. The success rate of interventional techniques was 93.94%, hemostatie rate was 90%. 3 eases died. Conclusion The embolization therapy is a safe and effective technique, should be as the first-line diagnostic and treatment choice for patients with post-pancreaticoduodenectomy bleeding.

关 键 词：手术后出血 胰十二指肠切除术 血管造影术 

分 类 号：R730.5[医药卫生—肿瘤]