综合手术救治方舱内采用不同栓塞材料救治脾破裂的对比研究  

Comparative Study of Using Different Embolic Agents Treatment Spleen Rupture in Comprehensive Operation Rescue Shelter

作　　者：陈丽[1,2] 梁明[2] 吕国军[1] 王为[1] 马小军[1] 韩雅玲[2] 

机构地区：[1]中国科学院大连化学物理研究所,辽宁大连116023 [2]沈阳军区总医院心血管内科,辽宁沈阳110016

出　　处：《现代生物医学进展》2013年第30期5864-5868,共5页Progress in Modern Biomedicine

基　　金：全军医学科学技术研究"十一五"计划第二批基金课题专项项目(08Z0001);全军"十二五"科研重点项目(后司(2012)463号;BWS12J006);辽宁省科全军技攻关课题(2011225006)

摘　　要：目的:探讨在战争或自然灾害等野战条件下,使用综合手术介入方舱,现场对脾脏实施快速微创介入栓塞的可行性及效果,对比分析综合手术救治方舱内采用不同栓塞材料介入救治脾破裂的适应症及有效性、安全性。方法:采用Seldinger技术,经股动脉插管至脾动脉,行数字减影血管造影术(DSA),显示出血动脉,然后超选择插管至该动脉,经导管注入不同类型栓塞剂以栓塞出血动脉。术后观察不同栓塞剂成功封堵受损血管所用时间,封堵时造影剂用量,封堵效果。结果:手术均成功,止血效果确切,无严重并发症。术后观察2周动物无死亡。结论:综合手术救治方舱具有良好的机动性和较强的自然环境适应能力,灾难现场应用综合手术救治方舱开展血管损伤应急介入救治具有可行性。根据血管损伤的不同类型,恰当选择不同类型的栓塞剂,可以取得很好的疗效。Objective： This study aimed to evaluate the feasibility and effectiveness of on-spot emergent transcatheter artcrial embolization for splenic injury in comprehensive operation rescue shelter following natural disasters or during wartime.Comparative analysis the indication, feasibility and safety of using different embolic agents interventional treatment traumatic spleen rupture in comprehensive operation rescue shelter. Methods： The catheter was inserted into spleen artery by seldinger＇s technique via the femoral artery and then DSA was performed to showed injured arteries.In order to embolize the bleeding arteries, The catheter was super-selectively inserted into the artery then different embolic agents were infused into it.Observe the time and the amount of contrast agent and effect of transcatheter closuring of damaged blood vessels successfully. Results： All the operation were successful, the hemostatic effect is good, here was no serious complication. All the animals were observed for two weeks,no animal died. Conclusion： Comprehensive operation rescue shelter has good mobility and environmental adaptability,which meets the requirement of minimally invasive interventional diagnosis and treatment of vascular injury in the shelter.According to the different types of vascular injury, appropriate selection of different types of embolization agent, can be achieved very good results.

关 键 词：抗震救灾 综合手术救治方舱 外伤性脾破裂 栓塞 

分 类 号：R657.62[医药卫生—外科学]