选择性动脉栓塞术在医源性出血中的应用  

Application of selective arterial embolization in the iatrogenic hemorrhage

作　　者：李梦迪[1] 陈勇[2] 高知玲[2] 薛彩娥[2] 马菁[2] 侯登华[2] 蔡磊[2] 陈兵[2] 郭玉林[2] 

机构地区：[1]宁夏医科大学临床医学院,宁夏银川750004 [2]宁夏医科大学总医院放射科

出　　处：《实用放射学杂志》2014年第11期1886-1889,共4页Journal of Practical Radiology

摘　　要：目的探讨选择性动脉栓塞术在治疗医源性出血中的临床应用价值。方法回顾性分析32例医源性出血患者资料，首先经皮选择性动脉造影，明确出血部位及特点，然后超选择性介入栓塞止血，栓塞材料选择明胶海绵、线段、弹簧圈及PVA颗粒等。结果32例患者中26例血管造影发现活动性出血征象，主要表现为对比剂外溢，伴有假性动脉瘤6例，伴有动静脉瘘1例，均成功施行介入栓塞止血，仅1例术后8d再次出血行二次栓塞治疗。本组病例术后随访1月，25例患者未出现严重并发症，1例多脏器功能衰竭死亡。6例血管造影阴性患者，3例失血性休克死亡，3例经内科治疗出血停止。结论选择性动脉栓塞术在医源性出血治疗中是一种安全、有效的措施。Objective To investigate the clinical application value of selective arterial embolization in the treatment of iatrogenic hemorrhage. Methods 32 cases with iatrogenic hemorrhage were retrospectively analyzed. The location and feature of bleeding were identified by selective percutaneous artery angioraphy , and then super-selective interventional embolization were performed. The embolic agents inclued gelfoam medical line, steel coils or polyvinyl alcohol （PVA） particles. Results In 32 patients, 26 cases with active bleeding signs were found by angiography, they mainly presented contrast medium overflow, 6 cases with pseudo-aneurysms, 1 case with arteriovenous fistula. All patients underwent interventional embolization successfully. Only 1 case underwent twice procedure because of rehaemorrhagia on the 8 days after embolization. Follow-up for a month after arterial embolization, 25 cases had no severe complications, 1 case died by multiple organ failure. In 6 negative cases, 3 cases died by hemorrhagic shock, 3 cases stopped hemorrhage after medical treatment. Conclusion Selective angiography is a safe and effective measure for the treatment of iatrogenic hemorrhage.

关 键 词：医源性 出血 栓塞 

分 类 号：R815[医药卫生—放射医学] R442.7[医药卫生—临床医学]