下腹部恶性肿瘤出血的介入栓塞治疗

王亮; 周汝明; 杨伟洪; 向先俊; 段海莹; 郭宗锦

doi:10.15953/j.1004-4140.2018.27.03.15

下腹部恶性肿瘤出血的介入栓塞治疗

香港大学深圳医院介入诊疗部, 广东深圳 518053

详细信息

作者简介:
王亮^*(1982-),男,香港大学深圳医院介入诊疗部主治医师,从事介入诊疗工作,擅长中晚期肝癌介入治疗,输卵管阻塞性不孕介入诊疗,Tel:0755-86913333-3795,E-mail:shiwuage@163.com。

中图分类号: R812;R445
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出版历程
- 收稿日期: 2018-02-28
- 网络出版日期: 2021-11-07

The Interventional Embolization for Hemorrhage Caused by Pelvic Malignant Tumor

The Interventional Department of the University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong Province 518053, China

摘要

摘要: 目的：探讨超选择性动脉栓塞术在下腹部恶性肿瘤出血的治疗价值。方法：选取香港大学深圳医院收治的下腹部恶性肿瘤导致便血、尿血或阴道出血的患者共11例，先在肾动脉开口上方行腹主动脉造影，然后分别插管进入肠系膜下动脉及双侧髂内动脉造影，判断出血或肿瘤供血血管后，行超选择性动脉栓塞术。术后观察出血是否减少或停止，栓塞后不良反应及并发症情况。结果：所有患者造影检查均获成功；除1例患者肠系膜下动脉超选择插管及1例患者腰动脉超选择插管未成功外，其余患者均对出血责任血管进行超选择性栓塞术。术后患者出血明显减少6例，出血完全停止5例；5例患者出现发热的不良反应；所有患者无严重的栓塞相关并发症发生；1例患者于术后6个月因再次出血而死亡。结论：超选择性动脉栓塞术治疗下腹部恶性肿瘤所致的出血是有效而相对安全的手段，在2周内，可以避免患者由于出血而死亡。重点栓塞的血管为肠系膜下动脉及患侧或双侧髂内动脉的肿瘤供血支。术后可以根据出血是否减轻来判断治疗效果。应用较大的明胶海绵颗粒可以避免术后发生严重并发症。
- 恶性肿瘤 /
- 出血 /
- 栓塞
Abstract: Objectives: To study the value of super-selected arterial embolization in treatment of pelvic malignant tumor hemorrhage. Methods: A total of 11 patients with hematuria, hematochezia or colporrhagia caused by pelvic malignant tumor admitted to our hospital were selected, all the patients carried on angiography of aorta abdominals, inferior mesenteric artery and bilateral internal iliac artery, and carried on selective artery embolization of responsible artery. Hemostasis, the occurrence of adverse reaction and complication were observed after embolization. Results: Angiography in all patients were successful, Super-selected angiography in 1 patient of inferior mesenteric artery failed because of stenosis, the other 1 patient of lumbar artery failed because of tortuous, the remaining patients underwent super-selective angiography and embolizafion of the responsible artery. Hemorrhage was significantly reduced in 6 patients, 5 patients stopped hemorrhage. 5 patients suffered fever after embolization; no severe complications were observed.1 patient died of re-bleeding after 6 months. Conclusion: Super-selective arterial embolization is effective and relatively safe in the treatment of hemorrhage caused by pelvic malignant tumor; at least in 2 weeks, it can avoid mortality caused by hemorrhage; The responsible artery vessels were mainly originated fi'om inferior mesenteric artery and unilateral or bilateral internal iliac artery; The curative effect can be judged according to whether the bleeding is reduced or not; Big diameter Gelatin Sponge Particle Embolic Agent was recommended in order to avoid severe complications after embolization.
- malignant tumor /
- hemorrhage /
- embolization

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