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目的:探讨在新型综合手术救治方舱中明胶海绵栓塞治疗肾血管损伤的可行性和疗效。方法:在新型综合手术救治方舱中构建3例动物肾腹(背)干动脉损伤模型、3例肾段动脉损伤模型,先用1 mm×1 mm×1 mm明胶海绵颗粒对损伤血管进行栓塞治疗,若未能止血,改用2 mm×2 mm×2 mm颗粒栓塞,观察栓塞后15分钟、1月后的肾动脉造影,栓塞后1月的组织病理表现。结果:3例肾段动脉和1例肾腹干动脉使用1 mm×1 mm×1 mm明胶海绵颗粒一次栓塞成功;1例肾腹干动脉和1例肾背干动脉用1 mm×1 mm×1 mm颗粒栓塞未能完全止血,改用2 mm×2 mm×2 mm颗粒栓塞成功。6例动物术后生命体征平稳,全部存活,一个月后造影复查见栓塞动脉未再通,但其余分支动脉血供得到保留。大体标本观栓塞侧肾明显缩小,未见脓腔和脓性分泌物,病理切片示栓塞后局部肾组织有不同范围缺血性梗死。结论:野战方舱中明胶海绵栓塞治疗出血效果明确,对于一般肾血管损伤定位准确,止血迅速、彻底,有良好的可行性和疗效。
Objective: To investigate the feasibility and efficacy of gelatin sponge embolization in the treatment of renal vascular injury in a new comprehensive surgical treatment cabin. Methods: Three animal models of kidney abdomen (dorsal) arterial injury and three models of renal artery injury were established in the new comprehensive surgical treatment cabin. The injured vessel was embolized with 1 mm × 1 mm × 1 mm gelatin sponge particles Treatment, if failed to stop bleeding, use 2 mm × 2 mm × 2 mm particle embolism, observed after embolization 15 minutes, 1 month after renal artery angiography, 1 month after embolization histopathological findings. Results: 3 cases of renal artery and 1 case of renal arteries were successfully embolized with 1 mm × 1 mm × 1 mm gelatin sponge. One case of renal artery and one case of renal artery included 1 mm × 1 mm × 1 mm particle embolization failed to completely stop bleeding, using 2 mm × 2 mm × 2 mm particle embolization success. The vital signs of 6 animals were stable and all survived. One month after angiography, the embolized artery was not recanalized, but the remaining branch arterial blood supply was preserved. The general view of the side of the embolization of the kidney was significantly reduced, no abscess and purulent secretions, pathological sections showed that local renal tissue after embolization have different ranges of ischemic infarction. Conclusion: The effect of gelatin sponge embolization on the hemorrhage is clear in the field shelter. It has the advantages of accurate positioning, rapid and thorough hemostasis, and good feasibility and curative effect.