Miura Fumihiko, Takada Tadahiro, Ochiai Takenori, Asano Takehide, Kenmochi Takashi, Amano Hodaka, Yoshida Masahiro
Department of Surgery, Teikyo University, School of Medicine, Tokyo, Japan.
J Gastrointest Surg. 2006 Apr;10(4):519-22. doi: 10.1016/j.gassur.2005.09.019.
Massive intraabdominal hemorrhage sometimes requires urgent hemostatic surgical intervention. In such cases, its rapid stabilization is crucial to reestablish a general hemodynamic status. We used an aortic occlusion balloon catheter in patients with massive intraabdominal hemorrhage occurring after hepato-pancreato-biliary surgery. An 8-French balloon catheter was percutaneously inserted into the aorta from the femoral artery, and the balloon was placed just above the celiac artery. Fifteen minutes inflation and 5 minutes deflation were alternated during surgery until the bleeding was surgically controlled. An aortic occlusion balloon catheter was inserted on 13 occasions in 10 patients undergoing laparotomy for hemostasis of massive hemorrhage. The aorta was successfully occluded on 12 occasions in nine patients. Both systolic pressure and heart rate were normalized during aortic occlusion, and the operative field became clearly visible after adequate suction of leaked blood. Bleeding sites were then easily found and controlled. Hemorrhage was successfully controlled in 7 of 10 patients (70%), and they were discharged in good condition. The aortic occlusion balloon catheter technique was effective for easily controlling massive intraabdominal bleeding by hemostatic procedure after hepato-pancreato-biliary surgery.
大量腹腔内出血有时需要紧急止血手术干预。在这种情况下，迅速稳定病情对于恢复全身血流动力学状态至关重要。我们在肝胰胆手术后发生大量腹腔内出血的患者中使用了主动脉阻断球囊导管。一根8法式球囊导管经皮从股动脉插入主动脉，球囊置于腹腔动脉上方。手术期间交替进行15分钟充气和5分钟放气，直到出血得到手术控制。10例因大量出血行剖腹手术止血的患者中有13次插入了主动脉阻断球囊导管。9例患者中有12次成功阻断了主动脉。主动脉阻断期间收缩压和心率均恢复正常，充分吸净漏出的血液后手术视野清晰可见。然后很容易找到并控制出血部位。10例患者中有7例（70%）出血得到成功控制，且均康复出院。主动脉阻断球囊导管技术对于肝胰胆手术后通过止血程序轻松控制大量腹腔内出血有效。
