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超声造影引导下经皮注射治疗钝性脾外伤

Percutaneous injection therapy for blunt splenic trauma guided by contrast-enhanced ultrasonography.

作者信息

Tang Jie, Zhang Huiqin, Lv Faqin, Li Wenxiu, Luo Yukun, Wang Yuexiang, Li Junlai

机构信息

Department of Ultrasound, Chinese People's Liberation Army General Hospital, 28 Fuxing Rd, 100853 Beijing, China.

出版信息

J Ultrasound Med. 2008 Jun;27(6):925-32; quiz 933. doi: 10.7863/jum.2008.27.6.925.

Abstract

OBJECTIVE

The purpose of this study was to investigate the application of contrast-enhanced ultrasonography (CEUS) in managing blunt splenic trauma and the effectiveness of CEUS-guided percutaneous injection therapy.

METHODS

Six patients with grade 3 or 4 splenic injuries as determined by CEUS and contrast-enhanced computed tomography were given hemocoagulase atrox and absorbable cyanoacrylate percutaneously, which were injected into the injury region and active bleeding site, respectively, under CEUS guidance. Immediately after the procedure and 1 and 3 days, 1 and 2 weeks, and 1 and 6 months after the procedure, follow-up CEUS up was performed in all patients.

RESULTS

Among the 6 patients, 4 cases of CEUS-guided hemostatic injection were successful without complications. Rehemorrhage occurred in 1 patient, and a traumatic arteriovenous fistula occurred in another; repeated injection therapy in these 2 patients was effective. During the follow-up, there were no complications, and spleen perfusion recovered gradually.

CONCLUSIONS

Contrast-enhanced ultrasonography can be used to guide percutaneous injection therapy and therefore achieve the goal of using interventional ultrasonography in managing splenic trauma.

摘要

目的

本研究旨在探讨超声造影(CEUS)在钝性脾外伤处理中的应用以及CEUS引导下经皮注射治疗的有效性。

方法

对6例经CEUS和增强CT检查确定为3级或4级脾损伤的患者,在CEUS引导下经皮分别给予矛头蝮蛇血凝酶和可吸收性氰基丙烯酸酯,分别注入损伤区域和活动性出血部位。术后即刻以及术后1天、3天、1周、2周、1个月和6个月,对所有患者进行随访CEUS检查。

结果

6例患者中,4例CEUS引导下止血注射成功,无并发症发生。1例患者发生再出血,另1例发生创伤性动静脉瘘;这2例患者重复注射治疗有效。随访期间无并发症发生,脾脏灌注逐渐恢复。

结论

超声造影可用于引导经皮注射治疗,从而实现介入超声在脾外伤处理中的应用目标。

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