经导管动脉栓塞术治疗肝动脉假性动脉瘤致脾切除1例并文献复习  

Splenectomy caused by transcatheter arterial embolization treating hepatic artery pseudoaneurysm:case report and literature review

作　　者：赵宝魁 马彦寿[2] 巴晓丽[3] ZHAO Baokui;MA Yanshou;BA Xiaoli(Qinghai Red Cross Hospital,Xining 810000,China;不详)

机构地区：[1]青海红十字医院,青海西宁810000 [2]青海省人民医院,青海西宁810007 [3]青海大学附属医院,青海西宁810001

出　　处：《现代医院》2020年第11期1697-1700,共4页Modern Hospitals

摘　　要：目的探讨及总结经导管动脉栓塞术(Transcatheter arterial embolization,TAE)治疗肝动脉假性动脉瘤(Hepatic artery pseudo aneurysm,HAPA)技术要点及栓塞材料选择,总结探讨避免该手术导致严重脾脏坏死、脾切除等严重并发症的经验。方法报道1例HAPA患者接受TAE后,因异位栓塞出现大面积脾缺血坏死,最终导致脾脏切除病例的临床资料,并对近十年发表的相关文献进行分析。结果本例患者TAE术中栓塞方法、栓塞材料选择不当,导致患者发生严重介入手术并发症脾栓塞,最终接受脾切除来避免病情进展危及生命。结论 TAE对HAPA的抢救治疗具有重要的临床价值,栓塞假性动脉瘤的流出、流入动脉及瘤体是合理的治疗原则。弹簧圈等易于X射线监视的材料是合适的栓塞材料。TAE治疗HAPA导致的异位栓塞等严重介入手术并发症应得到介入医师的重视。Objective To summarize the key points and appropriate embolic materials of transcatheter arterial embolization( TAE) in the treatment of hepatic artery pseudoaneurysm( HAPA),explore the measures for avoiding TAE-induced severe complications such as splenic necrosis and splenectomy. Methods The clinical data of a HAPA patient with such TAE-induced complications as massive splenic ischemia and necrosis treated eventually with splenectomy were analyzed. The relevant literatures on the case over the past decade were reviewed. Results In this case,the method of embolization and materials were not selected properly during TAE,which resulted in the serious complications due to splenic embolism. Finally,splenectomy was performed to save the life. Conclusion TAE has a great clinical value in the treatment of HAPA. Complete embolizing the outflow artery、inflow artery and the pseudoaneurysm is a reasonable treatment principle. Spring coil and other materials sensible for X-ray monitoring are suitable for embolization. Interventional physicians should pay more attention to severe complications caused by TAE such as ectopic embolism in the treatment of HAPA.

关 键 词：经导管动脉栓塞术 肝动脉假性动脉瘤 脾切除 病例报告 

分 类 号：R735.7[医药卫生—肿瘤] R732.21[医药卫生—临床医学]