| 金泳海,刘一之,倪才方,朱晓黎,邹建伟.外伤性大出血的急诊栓塞治疗[J].中国医学影像技术,2006,22(8):1227~1229 |
| 外伤性大出血的急诊栓塞治疗 |
| Transcatheter arterial embolization for emergency treatment of severely traumatic hemorrhage |
| 投稿时间：2006-04-11 修订日期：2006-08-08 |
| DOI： |
| 中文关键词: 出血,外伤性 栓塞,治疗性 |
| 英文关键词:Hemorrhage, traumatogenic Embolization, therapeutic |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨经导管靶动脉栓塞急诊治疗外伤性大出血的临床价值。方法 43例外伤性大出血患者,包括颅底骨折16例、肋骨骨折3例、肝、脾外伤各2例、肾外伤1例、下肢刀刺伤1例、骨盆骨折18例,经内科保守治疗无效和(或)难以耐受外科手术,在外伤后1~5 h行急诊血管造影,根据出血部位和造影结果,选用明胶海绵颗粒和细条、不锈钢圈及可脱球囊栓塞相应的靶动脉。结果 除3例颅底骨折和2例骨盆骨折患者在造影过程中死亡未行栓塞外,其余38例均在1.5 h内完成栓塞治疗,栓塞成功率88.4％(38/43),栓塞后活动性出血停止,失血性休克得到纠正,有效率达100％(38/38),其中35例经康复治疗后出院,2例因发生DIC,1例因合并颅脑损伤而死亡。无严重的栓塞后并发症出现。结论 经导管靶动脉栓塞是急诊治疗外伤性大出血的一种安全、有效、简便的方法。 |
| 英文摘要: |
| Objective To evaluate the clinical value of transcatheter arterial embolization for emergency treatment of severely traumatic hemorrhage. Methods Forty-three cases of traumatic hemorrhage who failed for conservative therapy or operation, including 16 cases of basicranial fracture, 3 cases of rib fracture, 2 cases of hepatic trauma, 2 cases of splenic trauma, 1 case of renal trauma, 1 case of lower limb stab, and 18 cases of pelvic fracture, were accepted urgent angiography and embolization in 1-5 hours after trauma. The target arteries were embolized with glutin sponge, steel coils or detachable balloons. Results Except 3 cases of basicranial fracture and 2 cases of pelvic fracture died in the course of angiography. The other 38 cases were successfully accepted embolization within 1.5 hours. The success rate was 88.4％ (38/43). Bleeding was controlled immediately with restoring of their vital sign after embolization. The effectiveness rate was 100% (38/38). Thirty-five cases were cured, and 2 cases died of DIC and 1 case died of brain trauma. No serious complications occurred. Conclusion Transcatheter arterial embolization is a more effective, safer and easier method for controlling the severely traumatic hemorrhage. |
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