Arterial Embolization for Controlling Life-threatening Traumatic Pelvic Hemorrhage

動脈栓塞控制威脅生命的外傷性骨盆腔出血

陳潓誼(Hui-Yi Chen) ； 陳中和(Jeon-Hor Chen) ； 陳永芳(Yung-Fang Chen) ； 曾元宏(Iuan-Hong Tzeng) ； 蔣咸嘉(Hsein-Jar Chiang) ； 莊宏洋(Hung-Yang Chuang) ； 沈戊忠(Wu-Chung Shen)

《Mid-Taiwan Journal of Medicine》 14卷1期 (2009/03) Pp. 16-26

https://doi.org/10.6558/MTJM.2009.14(1).3

摘要

背景／目的　動脈栓塞控制威脅生命的外傷性骨盆出血的分析。
方法　從2004年1月到2007年7月共3.5年的時問內，有40位血行動力不穩定的外傷性骨盆出血的病人接受血管攝影與栓塞治療。倘血管有受傷的直接徵象（例如：顯影劑外滲和假性動脈瘤）或間接徵象（例如：血管痙攣和扭曲）時，施行經動脈栓塞止血。
結果　共有36個(90%)病人需栓塞，其中有31位有顯影劑外滲，5位有血管受傷的間接徵象。五位病人(5/40, 12.5%)因懷疑再次骨盆動脈再出血而行二次血管攝影且栓塞。栓塞的成功率爲94.4%。在栓塞後追蹤3個月以上並沒有直接與栓塞相關的併發症。
結論　動脈栓塞是控制有生命威脅的外傷性骨盆出血既安全又有效的方法。

關鍵字

血管攝影 ； 栓塞 ； 骨盆出血 ； 骨盆外傷

並列摘要

Background/Purpose. To evaluate the effectiveness of transcatheter arterial embolization (TAE) for controlling arterial hemorrhage due to pelvic trauma.
Methods. In this retrospective study, we analyzed the surgical outcomes of 40 hemodynamically unstable patients who underwent pelvic angiography for traumatic pelvic hemorrhage during the period January 2004 to July 2007. TAE was performed when direct signs (eg, contrast extravasation and pseudoaneurysm) or indirect signs (eg, vasospasm and vessel tortuosity) of vascular injury were noted.
Results. Embolization was required in 36 (90%) patients. Indications included active contrast extravasation in 31 (86%) and indirect signs of vascular injury in 5 (13.9%). Repeated TAE for recurrent pelvic arterial hemorrhage during the same admission was necessary in 5 (13.9%) of the 36 patients. The success rate of embolization was 94.4%. All patients had been followed for at least 3 months. There were no complications directly associated with the embolization procedures during the follow-up period.
Conclusion. TAE is a safe and effective method for controlling life-threatening traumatic pelvic hemorrhage.

並列關鍵字

angiography ； embolization ； pelvic hemorrhage ； pelvic trauma