CAJ | 학술논문

目的：探讨选择性动脉栓塞术在治疗医源性出血中的临床应用价值。方法回顾性分析32例医源性出血患者资料,首先经皮选择性动脉造影,明确出血部位及特点,然后超选择性介入栓塞止血,栓塞材料选择明胶海绵、线段、弹簧圈及 PVA 颗粒等。结果32例患者中26例血管造影发现活动性出血征象,主要表现为对比剂外溢,伴有假性动脉瘤6例,伴有动静脉瘘1例,均成功施行介入栓塞止血,仅1例术后8 d 再次出血行二次栓塞治疗。本组病例术后随访1月,25例患者未出现严重并发症,1例多脏器功能衰竭死亡。6例血管造影阴性患者,3例失血性休克死亡,3例经内科治疗出血停止。结论选择性动脉栓塞术在医源性出血治疗中是一种安全、有效的措施。
목적：탐토선택성동맥전새술재치료의원성출혈중적림상응용개치。방법회고성분석32례의원성출혈환자자료,수선경피선택성동맥조영,명학출혈부위급특점,연후초선택성개입전새지혈,전새재료선택명효해면、선단、탄황권급 PVA 과립등。결과32례환자중26례혈관조영발현활동성출혈정상,주요표현위대비제외일,반유가성동맥류6례,반유동정맥루1례,균성공시행개입전새지혈,부1례술후8 d 재차출혈행이차전새치료。본조병례술후수방1월,25례환자미출현엄중병발증,1례다장기공능쇠갈사망。6례혈관조영음성환자,3례실혈성휴극사망,3례경내과치료출혈정지。결론선택성동맥전새술재의원성출혈치료중시일충안전、유효적조시。
Objective To investigate the clinical application value of selective arterial embolization in the treatment of iatrogenic hemorrhage.Methods 32 cases with iatrogenic hemorrhage were retrospectively analyzed.The location and feature of bleeding were identified by selective percutaneous artery angioraphy,and then super-selective interventional embolization were performed.The embolic agents inclued gelfoam medical line,steel coils or polyvinyl alcohol (PVA)particles.Results In 32 patients,26 cases with active bleeding signs were found by angiography,they mainly presented contrast medium overflow,6 cases with pseudo-aneurysms,1 case with ar-teriovenous fistula.All patients underwent interventional embolization successfully.Only 1 case underwent twice procedure because of rehaemorrhagia on the 8 days after embolization.Follow-up for a month after arterial embolization,25 cases had no severe compli-cations,1 case died by multiple organ failure.In 6 negative cases,3 cases died by hemorrhagic shock,3 cases stopped hemorrhage after medical treatment.Conclusion Selective angiography is a safe and effective measure for the treatment of iatrogenic hemor-rhage.