Goslings J C, van Delden O M
Trauma-unit, Afd. Chirurgie, Academisch Medisch Centrum/Universiteit van Amsterdam, Meibergdreef 9, 1005 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2007 Feb 10;151(6):345-52.
Angiography and embolisation are being increasingly used to control bleeding following abdominal and pelvic trauma. CT is a useful tool to select patients for such intervention-radiological angiography. The application ofangiography and embolisation requires a specific local infrastructure, logistics and expertise on the part of the radiologist, traumatologist and anaesthetist. The main indications for angiography and embolisation are: contrast blush on the CT scan and clinical signs of ongoing bleeding; they are also indicated as an adjunct to damage control procedures. Angiography and embolisation are successful in about 90% of the patients; complications occur in < 10% of the patients. An accurate estimate of the patient's physical condition, a correct assessment of the severity of the injury, and a multidisciplinary approach are important factors in the success of embolisation therapy.
血管造影和栓塞术在控制腹部和盆腔创伤后的出血方面应用越来越广泛。CT是选择患者进行此类介入性放射血管造影的有用工具。血管造影和栓塞术的应用需要放射科医生、创伤科医生和麻醉师具备特定的当地基础设施、后勤保障和专业知识。血管造影和栓塞术的主要指征为:CT扫描上的造影剂外渗和持续出血的临床体征;它们也作为损伤控制程序的辅助手段。血管造影和栓塞术在约90%的患者中取得成功;并发症发生在不到10%的患者中。准确评估患者的身体状况、正确评估损伤的严重程度以及多学科方法是栓塞治疗成功的重要因素。