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胆道术后假性动脉瘤破裂出血14例诊治分析

陈国度 孟翔飞 王敬 向昕

引用本文:
Citation:

胆道术后假性动脉瘤破裂出血14例诊治分析

详细信息
  • 中图分类号: R657.4

Diagnosis and treatment of hemobilia from ruptured false aneurysms after hepatobiliary surgery: An analysis of 14 cases

  • 摘要:

    目的探讨胆道术后假性动脉瘤破裂出血的诊治方法及预防。方法回顾性分析解放军总医院肝胆外科2002年1月至2012年3月收治的14例胆道术后假性动脉瘤破裂出血患者的临床资料。14例患者猝死4例,其余10例按不同诊断治疗方法分为3组:出血后保守治疗组2例;出血后立即行剖腹探查、止血术组5例;出血后立即行选择性数字减影血管造影(DSA)检查及介入栓塞(TAE)治疗组3例。对其诊治要点及预防措施进行探讨。结果本组病例死亡6例,治愈8例。保守治疗2例均失败(100%),后均接受DSA检查及TAE治疗,1例死亡;剖腹探查、止血5例,2例确诊(40%)后治愈(40%),余3例术后又接受DSA检查及TAE治疗,1例死亡;出血后立即行选择性DSA检查及TAE治疗组3例,确诊3例(100%),治愈3例(100%)。所有病例共行选择性DSA检查8例,确诊8例(100%),经TAE治疗9次(8例),有效8次(89%),治愈6例(75%);其中经2次TAE治疗1例,死亡2例。死亡病例中4例猝死,1例为2次TAE治疗后肝功能衰竭死亡,另1例为剖腹转栓塞止血后多脏器功能衰竭死亡。结论胆道术后假性动脉瘤破裂出血应早期诊...

     

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