急诊血管内栓塞治疗医源性胸腔内大出血的疗效分析  

Efficacy analysis of emergency endovascular embolization in the treatment of iatrogenic massive intrathoracic hemorrhage

作　　者：唐凡 张文广[1] 陈鹏飞[1] 张萌帆 黄郭灏 许琳惠 李应敬 王贾楠 朱兴书 段旭华[1] 韩新巍[1] 任建庄[1] TANG Fan;ZHANG Wenguang;CHEN Pengfei;ZHANG Mengfan;HUANG Guohao;XU Linhui;LI Yingjing;WANG Jia’nan;ZHU Xingshu;DUAN Xuhua;HAN Xinwei;REN Jianzhuang(Department of Interventional,the First Affiliated Hospital of Zheng zhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院介入科,河南郑州450052

出　　处：《实用放射学杂志》2023年第3期460-463,共4页Journal of Practical Radiology

摘　　要：目的分析急诊血管内栓塞治疗医源性胸腔内大出血的临床疗效。方法回顾性分析接受急诊血管内栓塞治疗的31例医源性胸腔内大出血患者的临床资料。通过评价急诊血管内栓塞治疗医源性胸腔内大出血的技术成功率、临床成功率及临床症状改善情况分析其疗效。结果医源性胸腔内大出血的急诊血管内栓塞治疗技术成功率100%,临床成功率90.3%。1例在血管内栓塞后24 h因急性呼吸衰竭抢救无效死亡。2例因栓塞后胸腔内再次活动性出血转外科手术。28例在急诊血管内栓塞治疗后失血性休克、呼吸困难、贫血等临床症状明显改善,其休克指数、血红蛋白、红细胞计数、红细胞压积、收缩压、舒张压与血氧饱和度较术前显著改善,差异有统计学意义。结论急诊血管内栓塞是治疗医源性胸腔内大出血的一种可行、安全、有效的微创治疗方式,值得在临床中推广应用。Objective To analyze the clinical efficacy of emergency endovascular embolization in the treatment of iatrogenic massive intrathoracic hemorrhage.Methods The clinical data of 31 patients with iatrogenic massive intrathoracic hemorrhage,who received emergency endovascular embolization treatment were analyzed retrospectively.The technical success rate,the clinical success rate and improvement of clinical symptoms were evaluated,and then the clinical efficacy of emergency endovascular embolization in the treatment of iatrogenic massive intrathoracic hemorrhage was analyzed.Results The technical success rate of emergency endovascular embolization in all patients with iatrogenic massive intrathoracic hemorrhage was 100%and the clinical success rate was 90.3%.One case still died of acute respiratory failure 24 hours after successful embolization.Two cases were respectively converted to surgical operation due to recurrent active intrathoracic hemorrhage after embolization.The clinical symptoms of hemorrhagic shock,dyspnea and anemia were distinctly improved in 28 cases after emergency endovascular embolization.Their data of the shock index,hemoglobin,red blood cell count,hematocrit,systolic blood pressure,diastolic blood pressure and blood oxygen saturation after emergency endovascular embolization were significantly improved with statistical significance,compared with those before operation.Conclusion Emergency endovascular embolization is a feasible,safe,effective and minimally invasive therapy for iatrogenic massive intrathoracic hemorrhage,which is worthy of clinical application.

关 键 词：医源性出血 胸腔内大出血 栓塞 

分 类 号：R442.7[医药卫生—诊断学] R655[医药卫生—临床医学] R815