国产医用胶在肝动脉出血栓塞中的应用  

Application of transcatheter hepatic arterial embolization with domestic medical adhesive in hepatic arterial bleeding

作　　者：许敏[1] 蒋天鹏[1] 宋杰[1] 安天志[1] 周石[1] 

机构地区：[1]贵州医科大学附属医院介入科,贵州贵阳550004

出　　处：《中国介入影像与治疗学》2016年第5期263-266,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨国产医用胶肝动脉出血栓塞的有效性和安全性。方法对17例肝动脉损伤出血患者采用福爱乐医用胶进行栓塞,其中肝癌血管破裂出血2例,医源性出血5例,外伤性出血10例。对所有患者均在造影明确出血部位后予以微导管超选择插管至出血部位,经微导管注入福爱乐医用胶＋碘化油混合液（比例为1∶1）进行栓塞。结果造影发现17例患者中3例对比剂外溢,6例为假性动脉瘤,6例为肝动静脉瘘,2例肝动静脉瘘合并假性动脉瘤。17例患者均成功栓塞,手术成功率100%（17/17）,福爱乐医用胶与超液化碘油混合物用量0.3~1.1ml,中位数0.60ml,栓塞所用时间11~23min,中位时间15min,栓塞所耗医用胶费用375~750元,中位数375元。随访30天,无患者复发出血,未发现术后严重并发症。结论福爱乐医用胶对肝动脉出血血管栓塞成功率高,安全、有效。Objective To assess the clinical utility and safety of transcatheter arterial embolization with domestic medical adhesive in treating hepatic artery bleeding.Methods A total of 17 patients with hepatic artery bleeding embolized with FAL were analyzed retrospectively,2were liver cancer artery rupture,iatrogenic hepatic arterial bleeding in 5patients and traumatic hepatic arterial bleeding in 10 patients.Super-selective transcatheter arterial embolization of hepatic bleeding artery with mixtures of FAL and iodized oil（1∶1）was performed in all patients when the lesions were found with radiography.Results The findings of radiography in 17 patients included extravasation of contrast（n=3）,pseudoaneurysm（n=6）,arteriovenous fistula（n=6）and arteriovenous fistula combining with pseudoaneurysm（n=2）.The rate of successful embolization was 100%（17/17）during the operation,the median volume of mixture of FAL and iodized oil was0.60ml（0.3—1.1ml）and the median operational time was 15minutes（11—23minutes）,the median cost of FAL was$375（$375-750）.No one appearred rebleeding and no serious complications occurred after the operation during the fellow-up（30days）.Conclusion FAL can be favourable embolic agent for the treatment of hepatic artery bleeding with high successful rate,definite safe and efficacious clinical effect.

关 键 词：栓塞 肝动脉出血 福爱乐医用胶 

分 类 号：R575[医药卫生—消化系统]