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目的总结经导管出血动脉栓塞术(transcatheter arterial embolization,TAE)对重症急性胰腺炎(SAP)并发腹腔内大出血的诊治经验。方法回顾性分析本胰腺外科中心2000年1月至2003年1月间19例SAP并发腹腔内大出血病人经TAE诊治的临床资料。结果TAE止血近期成功率89.5%(17/19),再出血发生率36.8%(7/19),再次TAE止血成功率71.4%(5/7)。结论SAP并发腹腔内大出血多为腐蚀性/感染性动脉瘤破裂出血,主要出血血管为脾动脉和胃十二指肠动脉;就紧急止血而言,TAE最有效;对于TAE止血失败或止血后复发出血者手术止血是必要的。
Objective To summarize the experience of transcatheter arterial embolization (TAE) in the diagnosis and treatment of severe intra-abdominal hemorrhage in patients with severe acute pancreatitis (SAP). Methods The clinical data of 19 patients with SAP complicated with intraperitoneal hemorrhage who underwent transcatheter arterial chemoembolization at the Pancreatic Surgery Center from January 2000 to January 2003 were analyzed retrospectively. Results The success rate of TAE hemostasis was 89.5% (17/19), the rate of rebleeding was 36.8% (7/19), and the success rate of TAE hemostasis was again 71.4% (5/7). Conclusions Most of intracerebral hemorrhage complicated with SAP is rupture of corrosive / infectious aneurysm. The main hemorrhagic vessels are splenic artery and gastroduodenal artery. TAE is most effective in emergency hemostasis. For TAE hemostasis failure or hemostasis recurrence Bleeding surgery to stop bleeding is necessary.