超选择动脉栓塞术治疗腹壁血肿  

Super-selective arterial embolization for the treatment of abdominal wall hematoma

作　　者：闫乐乐 季杰 马圆 刘孜卓 吕朋华 YAN Lele;JI Jie;MA Yuan;LIU Zizhuo;LV Penghua(Department of Interventional Radiology,Northern Jiangsu People′s Hospital,Yangzhou,Jiangsu Province 215000,China)

机构地区：[1]苏北人民医院介入科,江苏扬州215000

出　　处：《介入放射学杂志》2025年第2期165-169,共5页Journal of Interventional Radiology

摘　　要：目的探讨超选择动脉栓塞术治疗腹壁血肿的安全性和有效性。方法回顾性分析2018年1月至2023年12月江苏省苏北人民医院收治的11例腹壁血肿患者的临床资料,所有患者均接受血管造影和超选择动脉栓塞治疗,以技术成功率和临床有效率评价栓塞治疗有效性,以并发症发生率评价安全性。结果11例患者中位年龄70岁,女性占91%,体重指数(BMI)25.1 kg/m^(2)、皮下脂肪2.8 cm、国际标准化比率1.12。DSA显示8例患者(72%)有活动性出血征象,3例(28%)未发现活动性出血征象。DSA识别和栓塞18条责任血管,分别为腰动脉6条(33.3%)、旋髂深动脉5条(27.7%)、腹壁下动脉5条(27.7%)、髂腰动脉2条(11.3%),中位手术时间80 min,技术成功率为100%,临床有效率91%,没有发生与手术相关的重大并发症,中位住院时间为6 d。结论超选择动脉栓塞对于高龄、肥胖合并基础疾病的腹壁血肿患者是一种技术成功率和临床有效率高以及安全性好的治疗选择。Objective To investigate the safety and efficacy of super-selective arterial embolization in the treatment of abdominal wall hematoma.Methods The clinical data of 11 patients with abdominal wall hematoma,who were admitted to the Northern Jiangsu People′s Hospital of China from January 2018 to December 2023,were retrospectively analyzed.All patients received angiography together with super-selective arterial embolization.The effectiveness of embolization treatment was evaluated by the technical success rate and therapeutic effect,and the safety was evaluated by the incidence of complication.Results The median age of the 11 patients was 70 years,91%were female,with a body mass index(BMI)of 25.1 kg/m~2,subcutaneous fat thickness of 2.8 cm,and international normalized ratio(INR)of 1.12.DSA showed that 8 patients(72%)had active bleeding signs,3 patients(28%)had no active bleeding signs.Under DSA,a total of 18 responsible vessels,including 6 lumbar arteries(33.3%),5 deep circumflex iliac arteries(27.7%),5 inferior epigastric arteries(27.7%)and 2 iliolumbar arteries(11.3%),were identified and were treated with embolization.The median time spent for operation was 80 minutes.The technical success rate was 100%and the clinical effective rate was 91%.No operation-related major complications occurred,and the median hospital stay was 6 days.Conclusion For the abdominal wall hematoma in aged,obesity patients with underlying diseases,super-selective arterial embolization is a therapeutic method with high technical success rate,high clinical effective rate and satisfactory clinical safety.

关 键 词：腹壁血肿 超选择动脉栓塞 血管造影术 

分 类 号：R572[医药卫生—消化系统]