肝动脉介入栓塞在Ⅲ、Ⅳ和部分Ⅴ级外伤性肝破裂救治中的应用

肝脏 ›› 2022, Vol. 27 ›› Issue (7): 807-809.

肝动脉介入栓塞在Ⅲ、Ⅳ和部分Ⅴ级外伤性肝破裂救治中的应用

段建峰, 刘晓晨, 杨帆, 段昌虎, 吴林, 朱环, 赵李飞

723000 西安交通大学医学院附属汉中三二〇一医院肝胆外科

收稿日期:2021-08-25 出版日期:2022-07-31 发布日期:2022-08-25

Application of transcatheter arterial embolization in the treatment of grade Ⅲ, Ⅳ and partial grade Ⅴ traumatic hepatic rupture

DUAN Jian-feng, LIU Xiao-chen, YANG Fan, DUAN Chang-hu, WU Lin, ZHU Huan, ZHAO Li-fei

XI,an Jiao Tong University Medicine College Affiliated Hanzhong 3201 Hospital Hepatological Surgery Department, Shannxi 723000, China

Received:2021-08-25 Online:2022-07-31 Published:2022-08-25

摘要/Abstract

摘要： 目的探讨总结肝动脉介入栓塞(TAE)在Ⅲ、Ⅳ和部分Ⅴ级外伤性肝破裂诊治中的应用。方法 2014年7月至2020年12月,采用肝动脉介入栓塞(TAE)治疗严重外伤性肝破裂共168例,其中Ⅲ级损伤92例,Ⅳ级67例和和Ⅴ级9例,观察其疗效和相关并发症。结果 168例患者经TAE治疗后均达到肝破裂止血目的,无再出血发生,1例死亡;肝外伤TAE后期的主要并发症为肝周感染及肝脓肿,穿刺置管引流效果良好。结论对于Ⅲ级以上的肝外伤,甚至Ⅳ和部分Ⅴ级损伤,在可以排除肝脏主要大血管损伤的情况下,作为一种紧急止血措施,TAE具有诊断与治疗兼备,创伤更小,对机体生理机能影响更低的优势,安全有效。

关键词: 肝动脉栓塞, Ⅲ、Ⅳ和部分Ⅴ级, 肝破裂

Abstract: Objective To discuss the application of transcatheter arterial embolization (TAE) in the diagnosis, treatment of grade Ⅲ, Ⅳ and partial grade Ⅴ traumatic liver rupture.Methods A total of 168 severe traumatic liver rupture were treated with TAE from July 2014 to December 2020, including 92 cases with grade Ⅲ injury, 67 cases with grade Ⅳ injury and 9 cases with grade Ⅴ injury. Its efficacy and related complications were observed.Results All 168 patients achieved hemostasis after TAE and no re-bleeding events occurred. One patient died. The main complications of liver trauma in the late stage of TAE were perihepatic infection and liver abscess, and pipuncture tube drainage could achieve good efficacy.Conclusion Under the condition that the damage of major blood vessels in the liver are excluded, for liver trauma above grade Ⅲ, even grade Ⅳ and partial grade Ⅴ injuries, as an emergency hemostatic measure, TAE has the advantages of both diagnosis and treatment, less trauma and less impact on the physiological function of the body, which is safe and effective.

Key words: TAE, Grade Ⅲ, Ⅳ and partial grade Ⅴ, Traumatic hepatic rupture

段建峰, 刘晓晨, 杨帆, 段昌虎, 吴林, 朱环, 赵李飞. 肝动脉介入栓塞在Ⅲ、Ⅳ和部分Ⅴ级外伤性肝破裂救治中的应用[J]. 肝脏, 2022, 27(7): 807-809.

DUAN Jian-feng, LIU Xiao-chen, YANG Fan, DUAN Chang-hu, WU Lin, ZHU Huan, ZHAO Li-fei. Application of transcatheter arterial embolization in the treatment of grade Ⅲ, Ⅳ and partial grade Ⅴ traumatic hepatic rupture[J]. Chinese Hepatolgy, 2022, 27(7): 807-809.

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