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目的评价选择性血管造影及介入栓塞对外伤性大出血的临床价值及疗效。方法 34例外伤性大出血患者,经保守治疗无效,采用Seldinger技术,经股动脉插管后作选择性动脉血管造影,明确出血部位后,再超选择插入出血动脉内注入栓塞材料明胶海绵和(或)弹簧圈栓塞出血动脉。结果 34例患者除1例因合并颅脑损伤术后2 d死亡外,32例一次栓塞成功,1例经二次栓塞成功,总成功率97.1%。所有患者休克症状消失,血压稳定上升至正常水平,无严重并发症发生。21例患者出现不同程度栓塞后综合症,经对症处理后消退,无严重并发症;1个月后复查肝肾功能正常。结论外伤性大出血行介入栓塞治疗是一种简单、安全有效的诊疗方法,具有很高的临床应用价值。
Objective To evaluate the clinical value and curative effect of selective angiography and interventional embolization on traumatic hemorrhage. Methods Thirty-four patients with traumatic hemorrhage were treated conservatively. Seldinger technique was used to make selective arterial angiography after femoral artery catheterization. After the bleeding site was clearly identified, hemorrhage was surgically injected with embolic material gelatin sponge and / Coil embolization bleeding artery. Results Of the 34 patients, only one of the 34 patients died after 2 days of operation due to brain injury. One of the 34 patients succeeded in the second embolization and the success rate was 97.1%. All patients with symptoms of shock disappeared, blood pressure rose to normal levels stable, no serious complications. 21 patients with varying degrees of post-embolic syndrome, after symptomatic treatment subsided, no serious complications; 1 month after the review of liver and kidney function was normal. Conclusion Interventional embolization with traumatic hemorrhage is a simple, safe and effective method of diagnosis and treatment, which has high clinical value.