部分脾动脉栓塞治疗创伤性脾破裂  

Treatment of traumatic rupture of spleen by partial splenic embolization

作　　者：解光艾[1] 赵涛[1] 刘永庆[1] 王高生[1] 叶勇[1] 吕德超[1] 

机构地区：[1]安徽省立医院急救中心外科,安徽合肥230001

出　　处：《创伤外科杂志》2004年第2期106-108,共3页Journal of Traumatic Surgery

摘　　要：目的　探讨部分脾动脉栓塞 (PSE)治疗创伤性脾破裂的效果。方法　采用Seldinger技术 ,经股动脉插管至脾动脉行数字减影血管造影术 (DSA) ,显示出血动脉 ,然后超选择插管至该动脉 ,经导管注入明胶海绵颗粒以栓塞出血动脉。于麦氏点局麻下经皮穿刺置入“猪尾巴”引流管引流腹腔积血 ,无污染、无溶血的积血可以回输。术后 3、6个月分别作B超、CT、99mTC检查监测脾脏形态、密度、血供情况 ,测定血小板及血中IgM、IgG、C3 水平。结果　本组 35例创伤性脾破裂 ,经PSE后止血效果确切 ,脾脏形态、功能正常 ,无严重并发症。结论　有选择性地对创伤性脾破裂行PSE ,其止血可靠、创伤小。Objective To study the effect of partial splenic embolization(PSE)in the treatment of traumatic spleen rupture.?Methods The catheter was inserted into spleen artery by Seldinger's technique via the femoral artery and then DSA was performed to show the injured arteries.?In order to embolize the bleeding arteries,the catheter was super selectively inserted into the artery then Gelfoam particles were infused into it.?Under local anesthesia,the “Pigtail”tube was placed at Mc Burney's point to drain blood that remained in abdominal cavity.?If the blood was not contaminated or hemolytic,the blood could be transfused.?After operation,B type ultrasonic wave,CT and 99m T C were implemented 3,6 months respectively to detect the morphology,density and blood supply of the spleen.?The number of platelets and the level of IgM,IgG,C 3 in serum were tested.?Results Among the total 35 cases treated with PSE,the morphology of spleens and immunologic parameters were normal,the effect of hemostasis was also satisfactory.?Conclusion PSE is an effective therapy in the selective treatment of spleen rupture.?There is nocomplication.?It is safe,reliable and the injury is minimal.

关 键 词：脾破裂 创伤 脾动脉栓塞 

分 类 号：R657.62[医药卫生—外科学]