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目的探讨肝动脉化疗栓塞术在治疗肝破裂出血中的疗效。方法 1999年6月至2012年10月收治26例肝破裂出血患者,其中肝癌24例,肝血管瘤2例。紧急行经皮穿刺股动脉插管肝动脉栓塞术治疗,前15例注入明胶海绵颗粒+对比剂栓塞,后11例注入适量超液化碘油和明胶海绵颗粒+对比剂栓塞,观察止血效果、预后。结果有效止血25例,术后观察2周无复发出血和急性肝功能衰竭。1例术后1d发现出血未止,转外科手术。随访、复查中均未出现再次出血。结论急诊肝动脉栓塞术是治疗肝破裂出血安全有效的手段,可达到立即止血的目的,同时为诊断、进一步治疗提供帮助。
Objective To investigate the efficacy of transcatheter arterial chemoembolization in the treatment of hepatic rupture hemorrhage. Methods From June 1999 to October 2012, 26 patients with hepatic rupture hemorrhage were admitted, including 24 hepatocellular carcinoma and 2 hepatic hemangioma. Emergency percutaneous puncture of femoral artery embolization of hepatic artery embolization, the first 15 cases injected gelatin sponge particles + contrast embolization, after injection of 11 cases of excessive liquefied iodized oil and gelatin sponge particles + contrast embolization, to observe the bleeding effect and prognosis. The results of effective hemostasis in 25 cases, no recurrence of bleeding and acute liver failure observed after 2 weeks. One patient found bleeding on 1d after operation and switched to surgery. Follow-up, review did not appear again bleeding. Conclusion Emergency hepatic arterial embolization is a safe and effective method for the treatment of hepatic rupture and can achieve immediate hemostasis. At the same time, it is helpful for the diagnosis and further treatment.