急诊介入治疗急性大出血的探讨

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1、急诊介入治疗急性大出血的探讨摘要：目的：探讨急诊介入治疗各种急性大出血的诊疗与技术要点。方法：回顾性研究2006年1月至2013年12月我院介入科行急诊介入治疗各种急性大出血184例，通过血管造影明确出血血管后，超选择插管至出血动脉，运用明胶海绵、丝线、弹簧圈和聚乙烯醇颗粒进行栓塞。结果：184例中有171例明确出血血管，实施栓塞术，12例消化道大出血DSA检查未能确定出血部位，1例大咯血未找到支气管动脉至造影失败。171例介入治疗患者中治愈132例，显效26例，无效14例，总有效率为92%。无发生严重并发症。结论:我们总结出“二快”、“二定”、

2、“三合理”的治疗原则。运用这项治疗原则有利于介入医生综合应对各种急性大出血的处置，对于保证介入手术成功、挽救患者生命能发挥积极作用。关键词：急性大出血；急诊介入治疗；血管造影；栓TheinvestigationofemergencyinterventionforthetreatmentofvariousacutemassivehemorrhageLUOhai-long，LINyou-en，HONGxiao~tao,LUOzhe-pen，ZHENGming-kai，ZUyi-feng，ZENGli-tingMinimallyInvasiveCent

3、er&InterventionRoomoftheRadiologyDepartmentofJieyangPeople’sHospital,GuangdongProvinceAbstract：ObjectiveTheClinicalandtechnicalpointsofemergencyinterventionwasevaluatedforthetreatmentofvariousacutemassivehemorrhage.MethodsRetrospectivestudy.Ourstudyincludedtotally184patientsw

4、ithvariousacutemassivehemorrhagefromJanuary2006toDecember2013.Weusedangiographytoconfirmthebleedingvessels,andthengetintothebleedingvesselsbysuperselectivecatheterization,thenimplementedembolizationusinggelatinsponge，silkthreads,coilsandpolyvinylalcoholparticles.Results①Among

5、all184patients,weimplementedembolizationfor171patients.12patientswerefailedtodefinethesiteofhemorrhage,1patientofmassivehemoptysisquittedfromthestudybecausewefailedtodefinethebronchialartery.②Among171patients,132patientsweresuccessfullytreated，26patientsresultedinuncompletely

6、hemostasis,14patientswereconsideredasinvalid,thetotalefficientwas92%.(3)Nosevereadverseeventsoccurred.ConclusionInourstudy，wesummedupaprincipleas“rapiddiagnosis,quicklyintervention”，“locatethelocationofthehemorrhage，definethecauseofthebleeding’，，“reasonableuseoftargetvessels,

7、embolicmaterialsanddegreeofembolization，’•Onthebasisofthisprinciple,emergencyinterventioniseffectiveforthetreatmentofvariousacutemassivehemorrhagesoastoimprovethesuccessrateofinterventionaloperationandsavethelivesofpatients.Keywords:AcuteMassiveHemorrhage；EmergencyInterventio

8、ntherapy；Angiography；Embolization【中图分类号】R249【文献标识码】B【文章编号】1002-3763(