超选择靶血管栓塞治疗腹盆部自发性出血  

Super-selective target artery embolization for the treatment of abdominopelvic spontaneous hemorrhage

作　　者：李智[1] 胡波[1] 金泳海[1] 倪才方[1] LI Zhi;HU Bo;JIN Yonghai;NI Caifang(Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]苏州大学附属第一医院介入科,江苏215006

出　　处：《介入放射学杂志》2021年第1期48-51,共4页Journal of Interventional Radiology

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(LGY2018077)。

摘　　要：目的探讨超选择性靶血管栓塞治疗腹盆部自发性出血的临床价值。方法回顾性分析2016年1月至2018年12月苏州大学附属第一医院诊治的10例腹盆部自发性出血患者临床资料。所有患者均接受介入造影和超选择栓塞治疗,术前CT检查9例,加增强CT扫描5例。以技术成功率和临床有效率评价介入治疗效果,以介入相关并发症评价安全性。结果超选择靶动脉栓塞术成功率为80%(8/10),临床有效率77.8%(7/9)。9例术前CT检查中,5例见哨兵血块征,1例见红细胞压积征;5例平扫+增强CT扫描中,4例见对比剂外溢征,与DSA血管造影出血部位吻合。术后30 d内死亡2例,8例随访2~27个月,无介入治疗相关并发症,无再发出血。结论超选择靶血管栓塞是治疗腹盆部自发性出血的安全有效的方法。增强CT有助于诊断和寻找出血部位。Objective To discuss the clinical value of super-selective target artery embolization in the treatment of abdominopelvic spontaneous hemorrhage. Methods The clinical data of 10 patients with abdominopelvic spontaneous hemorrhage,who were admitted to the First Affiliated Hospital of Soochow University of China during the period from January 2016 to December 2018 to receive treatment,were retrospectively analyzed. All patients received angiography and super-selective target artery embolization.Preoperative CT examination was performed in 9 patients and contrast-enhanced CT scan was employed in 5 patients. The clinical curative effect of interventional therapy was evaluated based on the technical success rate and the clinical effective rate,and the safety was assessed according to the incidence of intervention-related complications. Results The technical success rate of super-selective target artery embolization was 80%(8/10),and the clinical effective rate was 77.8%(7/9). Preoperative CT examination in 9 patients showed that the sentinel clot sign was observed in 5 patients and hematocrit sign was detected in one patient. Among the 5 patients who received both plain and contrast-enhanced CT scan the contrast material extravasation sign was seen in 4,their bleeding sites were in consistence with those displayed on DSA angiography. Two patients died within 30 days after treatment. Eight patients were followed up for 2-27 months,and no interventionrelated complications or recurrent hemorrhage occurred. Conclusion For the treatment of abdominopelvic spontaneous hemorrhage,super-selective target artery embolization is a safe and effective method. Contrastenhanced CT scan is helpful for making the diagnosis and finding out the bleeding sites.(J Intervent Radiol,2021,30: 48-51)

关 键 词：自发性出血 超选择性栓塞 数字减影血管造影术 对比剂外溢 

分 类 号：R614.2[医药卫生—麻醉学]