腰动脉栓塞治疗经皮椎间孔镜引起的大出血4例  

Lumbar artery embolization for the treatment of massive hemorrhage caused by percutaneous transforaminal endoscopic discectomy: preliminary experience in 4 patients

作　　者：陈水兵[1] 虞希祥 

机构地区：[1]浙江温州医科大学附属第二医院育英儿童医院介入科,325000 [2]温州市人民医院介入血管外科

出　　处：《介入放射学杂志》2017年第11期1033-1037,共5页Journal of Interventional Radiology

摘　　要：目的探讨腰动脉栓塞治疗经皮椎间孔镜术(PTED)引起的大出血的疗效及安全性。方法对4例PTED引起的大出血患者行腰动脉造影,根据腰动脉造影情况,以微粒和弹簧圈进行栓塞治疗。结果 3例患者腰动脉造影可见对比剂外溢,1例患者腰动脉造影可见假性动脉瘤。4例患者腰动脉栓塞后出血完全停止,随访1~3个月均无再次出血及严重并发症发生。结论 PTED引起的大出血内科和外科处理都比较困难,腰动脉栓塞治疗PTED引起的大出血安全、有效、微创,值得借鉴和推广。Objective To evaluate the curative effect and safety of lumbar artery embolization in treating massive hemorrhage caused by percutaneous transforaminal endoscopic discectomy （PTED）. Methods From January 2013 to December 2016, lumbar artery angiography was performed in 4 patients with massive hemorrhage caused by PTED. Based on the angiographic findings, lumbar artery embolization therapy with embolic microspheres and spring coils was carried out. Results Lumbar artery angiography revealed that extravasatiou of contrast agent was detected in 3 patients and pseudoaneurysm in one patient. The bleeding completely stopped immediately after lumbar artery embolization in all 4 patients. The patients were followed up for 1-3 months, and no re-bleeding or serious complications occurred. Conclusion It is very difficult to make medical and surgical management for massive hemorrhage caused by FRED. Lumbar artery embolization is safe, effective and minimally-invasive for the treatment of massive hemorrhage caused by PTED. This therapy is worthy of clinical use.

关 键 词：经皮椎间孔镜 出血 腰动脉 栓塞 

分 类 号：R687.3[医药卫生—骨科学]