Department of Surgery, Wright State University, Dayton, OH, USA.
Am J Surg. 2013 Mar;205(3):250-4; discussion 254. doi: 10.1016/j.amjsurg.2013.01.003. Epub 2013 Jan 31.
Splenic artery embolization (SAE) is a staple adjunct in the management of blunt splenic trauma. We examined complications of SAE over an 11-year period.
Patients who underwent SAE were identified. Demographic data and the location of the SAE-proximal, distal, or combined-were noted. Major and minor complications were identified.
Of 1,383 patients with blunt splenic trauma, 298 (21.5%) underwent operative management, and 1,085 (78.5%) underwent nonoperative management (NOM). SAE was performed in 8.1% of the NOM group. Major complications which occurred in 14% of patients, included splenic abscesses, infarction, cysts, and contrast-induced renal insufficiency. Three-fourths of patients with major complications underwent distal embolization. There were more complications in patients who underwent distal embolization (24% distal vs 6% proximal alone; P = .02). Minor complications, which occurred in 34% of patients, included left-sided pleural effusions, coil migration, and fever.
SAE is a useful tool for managing splenic injuries. Major and minor complications can occur. Distal embolization is associated with more major complications.
脾动脉栓塞术（SAE）是治疗钝性脾外伤的主要辅助手段。我们研究了 11 年间 SAE 的并发症。
确定接受 SAE 的患者。记录人口统计学数据和 SAE 的位置（近端、远端或两者结合）。确定主要和次要并发症。
在 1383 例钝性脾外伤患者中，298 例（21.5%）接受了手术治疗，1085 例（78.5%）接受了非手术治疗（NOM）。NOM 组中有 8.1%的患者进行了 SAE。主要并发症发生率为 14%，包括脾脓肿、梗死、囊肿和造影剂诱导的肾功能不全。四分之三的主要并发症患者接受了远端栓塞。远端栓塞的患者并发症更多（远端栓塞 24%，单纯近端栓塞 6%；P =.02）。次要并发症发生率为 34%，包括左侧胸腔积液、线圈移位和发热。
SAE 是治疗脾损伤的有效工具。可能发生主要和次要并发症。远端栓塞与更多的主要并发症相关。
