多层螺旋CT联合介入栓塞术对创伤性肝脾破裂出血患者血流动力学的影响  

Effect of multi-slice spiral CT combined with interventional embolization on hemodynamics in patients with traumatic liver and spleen rupture bleeding

作　　者：杨志科 严志军 许华权 夏琦 胡兴飞 YANG Zhike;YAN Zhijun;XU Huaquan(Department of Radiology DSA Room,The First People's Hospital of Daishan County,Daishan 316200,China)

机构地区：[1]岱山县第一人民医院放射科DSA室,浙江岱山316200 [2]岱山县第一人民医院医学影像中心,浙江岱山316200 [3]岱山县第一人民医院普外科,浙江岱山316200 [4]岱山县第一人民医院放射科,浙江岱山316200

出　　处：《全科医学临床与教育》2025年第2期125-128,共4页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划项目(2023XY233)。

摘　　要：目的探讨多层螺旋CT联合介入栓塞术对创伤性肝脾破裂出血患者血流动力学的影响。方法选取80例创伤性肝脾破裂出血患者进行回顾性分析,根据不同治疗方法分组:采用超声造影引导下介入止血治疗38例患者为对照组,采用多层螺旋CT联合介入栓塞术治疗的42例患者为观察组。比较两组治疗相关指标、血流动力学、血红蛋白、血小板水平和并发症发生率。结果观察组患者的止血时间、住院时间均短于对照组,差异均有统计学意义(t分别=-18.97、-3.21,P均<0.05);两组伤后至治疗时间、止血成功率比较,差异均无统计学意义(t=0.20,χ^(2)=0.05,P均>0.05);治疗后,观察组平均动脉压、中心静脉压、血红蛋白、血小板水平均高于对照组,心率低于对照组,差异均有统计学意义(t分别=2.25、2.33、2.55、3.00、-3.21,P均<0.05),观察组患者的并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.06,P<0.05)。结论在创伤性肝脾破裂出血患者中应用多层螺旋CT联合介入栓塞术,可有效缩短止血时间,促进患者血流动力学水平稳定。Objective To explor the effect of multi-slice spiral CT combined with interventional embolization on hemodynamics in patients with traumatic liver and spleen rupture bleeding.Methods A retrospective analysis was performed on 80 patients with traumatic hepatosplenic rupture and hemorrhage.According to different treatment methods,38 patients in control group were treated with interventional hemostasis guided by contrast-enhanced ultrasound,and 42 patients in observation group were treated with multi-slice spiral CT combined with interventional embolization.Treatment related indexes,hemodynamics,hemoglobin,platelet levels and complication incidence were compared between the two groups.Results The hemostatic time and hospital stay in observation group were shorter than those in control group,and the differences were statistically significant(t=-18.97,-3.21,P<0.05).There were no significant differences in the time from injury to treatment and the success rate of hemostasis between the two groups(t=0.20,χ^(2)=0.05,P>0.05).After treatment,the mean arterial pressure,central venous pressure,hemoglobin and platelet levels in the observation group were higher than those in the control group,and the heart rate was lower than that in the control group,with statistical significance(t=2.25,2.33,2.55,3.00,-3.21,P<0.05).The complication rate of the observation group was lower than that of the control group,and the difference was statistically significant(χ^(2)=4.06,P<0.05).Conclusion The application of multi-slice spiral CT combined with interventional embolization can effectively shorten the hemostatic time and promote the stability of hemodynamic level in patients with traumatic hepatosplenic rupture and hemorrhage.

关 键 词：多层螺旋CT 介入栓塞术 超声造影介入止血 创伤性肝脾破裂出血 

分 类 号：R47[医药卫生—护理学]