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[钝性腹部创伤非手术治疗策略中的同期器官血管栓塞术]

[Simultaneous organ angioembolization in nonoperative treatment strategy of blunt abdominal trauma].

作者信息

Velez Sebastian Eduardo

机构信息

hospital municipal de urgencias.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2017 Sep 8;74(3):207-213. doi: 10.31053/1853.0605.v74.n3.14483.

Abstract

BACKGROUND

nonoperative treatment (TNO) is suggested in blunt abdominal trauma in stable patients without necessarily addressing surgical trauma injuries. Among the tools used, it has highlighted the angioembolization as a method of stopping bleeding or potentially bleeding lesions. The existence of more than one lesion may be possible to treat this way. Objectives: to show the experience of a hospital emergency department in the use of angioembolization in nonoperative management of more than one injured abdominal organ. Demonstrate utility of simultaneous angioembolization of more than one vascular territory or organ in the management of patients with blunt abdominal trauma who start a nonoperative treatmeant. Design: Retrospective observational study Methods: Between 2007 and 2014, patients with blunt abdominal trauma and active hemorrhage or potentially bleeding lesions demonstrated by computed tomography (CT) were evaluated. Those who underwent nonoperative treatment and embolized were included. Of these, those with more than one organ or vascular territory embolized were described. Results: 392 patients were admitted with blunt abdominal trauma. Of these, 281 (72 %) started TNO protocol. 225 with active bleeding on CT were found. 183 patients (80 %) underwent angiography and 166 need embolization. In 7 cases embolization of more than one organ or vascular territory was performed. Conclusion: angioembolization of organ with active bleeding is definitely accepted practice in trauma centers. The opportunity and need for more than one organ embolization or vascular territory is scarce, but it is doable when adjusted to existing protocols, respecting especially hemodynamic stability

OBJECTIVES

to show the experience of a hospital emergency department in the use of angioembolization in nonoperative management of more than one injured abdominal organ. Demonstrate utility of simultaneous angioembolization of more than one vascular territory or organ in the management of patients with blunt abdominal trauma who start a nonoperative treatmeant. Design: Retrospective observational study Methods: Between 2007 and 2014, patients with blunt abdominal trauma and active hemorrhage or potentially bleeding lesions demonstrated by computed tomography (CT) were evaluated. Those who underwent nonoperative treatment and embolized were included. Of these, those with more than one organ or vascular territory embolized were described. Results: 392 patients were admitted with blunt abdominal trauma. Of these, 281 (72 %) started TNO protocol. 225 with active bleeding on CT were found. 183 patients (80 %) underwent angiography and 166 need embolization. In 7 cases embolization of more than one organ or vascular territory was performed. Conclusion: angioembolization of organ with active bleeding is definitely accepted practice in trauma centers. The opportunity and need for more than one organ embolization or vascular territory is scarce, but it is doable when adjusted to existing protocols, respecting especially hemodynamic stability

DESIGN

Retrospective observational study Methods: Between 2007 and 2014, patients with blunt abdominal trauma and active hemorrhage or potentially bleeding lesions demonstrated by computed tomography (CT) were evaluated. Those who underwent nonoperative treatment and embolized were included. Of these, those with more than one organ or vascular territory embolized were described. Results: 392 patients were admitted with blunt abdominal trauma. Of these, 281 (72 %) started TNO protocol. 225 with active bleeding on CT were found. 183 patients (80 %) underwent angiography and 166 need embolization. In 7 cases embolization of more than one organ or vascular territory was performed. Conclusion: angioembolization of organ with active bleeding is definitely accepted practice in trauma centers. The opportunity and need for more than one organ embolization or vascular territory is scarce, but it is doable when adjusted to existing protocols, respecting especially hemodynamic stability

METHODS

Between 2007 and 2014, patients with blunt abdominal trauma and active hemorrhage or potentially bleeding lesions demonstrated by computed tomography (CT) were evaluated. Those who underwent nonoperative treatment and embolized were included. Of these, those with more than one organ or vascular territory embolized were described. Results: 392 patients were admitted with blunt abdominal trauma. Of these, 281 (72 %) started TNO protocol. 225 with active bleeding on CT were found. 183 patients (80 %) underwent angiography and 166 need embolization. In 7 cases embolization of more than one organ or vascular territory was performed. Conclusion: angioembolization of organ with active bleeding is definitely accepted practice in trauma centers. The opportunity and need for more than one organ embolization or vascular territory is scarce, but it is doable when adjusted to existing protocols, respecting especially hemodynamic stability

RESULTS

392 patients were admitted with blunt abdominal trauma. Of these, 281 (72 %) started TNO protocol. 225 with active bleeding on CT were found. 183 patients (80 %) underwent angiography and 166 need embolization. In 7 cases embolization of more than one organ or vascular territory was performed.

CONCLUSION

angioembolization of organ with active bleeding is definitely accepted practice in trauma centers. The opportunity and need for more than one organ embolization or vascular territory is scarce, but it is doable when adjusted to existing protocols, respecting especially hemodynamic stability

摘要

背景

对于病情稳定的钝性腹部创伤患者,建议采用非手术治疗(TNO),不一定需要处理手术创伤损伤。在使用的工具中,血管栓塞术作为一种止血或潜在止血病变的方法备受关注。存在多个病变时,有可能通过这种方式进行治疗。

目的

展示一家医院急诊科在钝性腹部创伤中使用血管栓塞术对多个受损腹部器官进行非手术治疗的经验。证明在对开始非手术治疗的钝性腹部创伤患者进行管理时,同时对多个血管区域或器官进行血管栓塞术的效用。

设计

回顾性观察研究

方法

2007年至2014年期间,对经计算机断层扫描(CT)显示有钝性腹部创伤且有活动性出血或潜在出血病变的患者进行评估。纳入接受非手术治疗并进行栓塞的患者。其中,描述了栓塞多个器官或血管区域的患者情况。

结果

392例患者因钝性腹部创伤入院。其中,281例(72%)开始TNO方案。CT显示有225例活动性出血。183例患者(80%)接受了血管造影,166例需要栓塞。7例患者对多个器官或血管区域进行了栓塞。

结论

对有活动性出血的器官进行血管栓塞术在创伤中心绝对是公认的做法。对多个器官或血管区域进行栓塞的机会和需求很少,但在根据现有方案进行调整时是可行的,尤其要注意血流动力学稳定性。

目的

展示一家医院急诊科在钝性腹部创伤中使用血管栓塞术对多个受损腹部器官进行非手术治疗的经验。证明在对开始非手术治疗的钝性腹部创伤患者进行管理时,同时对多个血管区域或器官进行血管栓塞术的效用。

设计

回顾性观察研究

方法

2007年至2014年期间,对经计算机断层扫描(CT)显示有钝性腹部创伤且有活动性出血或潜在出血病变的患者进行评估。纳入接受非手术治疗并进行栓塞的患者。其中,描述了栓塞多个器官或血管区域的患者情况。

结果

392例患者因钝性腹部创伤入院。其中,281例(72%)开始TNO方案。CT显示有225例活动性出血。183例患者(80%)接受了血管造影,166例需要栓塞。7例患者对多个器官或血管区域进行了栓塞。

结论

对有活动性出血的器官进行血管栓塞术在创伤中心绝对是公认的做法。对多个器官或血管区域进行栓塞的机会和需求很少,但在根据现有方案进行调整时是可行的,尤其要注意血流动力学稳定性。

设计

回顾性观察研究

方法

2007年至2014年期间,对经计算机断层扫描(CT)显示有钝性腹部创伤且有活动性出血或潜在出血病变的患者进行评估。纳入接受非手术治疗并进行栓塞的患者。其中,描述了栓塞多个器官或血管区域的患者情况。

结果

392例患者因钝性腹部创伤入院。其中,281例(72%)开始TNO方案。CT显示有225例活动性出血。183例患者(80%)接受了血管造影,166例需要栓塞。7例患者对多个器官或血管区域进行了栓塞。

结论

对有活动性出血的器官进行血管栓塞术在创伤中心绝对是公认的做法。对多个器官或血管区域进行栓塞的机会和需求很少,但在根据现有方案进行调整时是可行的,尤其要注意血流动力学稳定性。

方法

2007年至2014年期间,对经计算机断层扫描(CT)显示有钝性腹部创伤且有活动性出血或潜在出血病变的患者进行评估。纳入接受非手术治疗并进行栓塞的患者。其中,描述了栓塞多个器官或血管区域的患者情况。

结果

392例患者因钝性腹部创伤入院。其中,281例(72%)开始TNO方案。CT显示有225例活动性出血。183例患者(80%)接受了血管造影,166例需要栓塞。7例患者对多个器官或血管区域进行了栓塞。

结论

对有活动性出血的器官进行血管栓塞术在创伤中心绝对是公认的做法。对多个器官或血管区域进行栓塞的机会和需求很少,但在根据现有方案进行调整时是可行的,尤其要注意血流动力学稳定性。

结果

392例患者因钝性腹部创伤入院。其中,281例(72%)开始TNO方案。CT显示有225例活动性出血。183例患者(80%)接受了血管造影,166例需要栓塞。7例患者对多个器官或血管区域进行了栓塞。

结论

对有活动性出血的器官进行血管栓塞术在创伤中心绝对是公认的做法。对多个器官或血管区域进行栓塞的机会和需求很少,但在根据现有方案进行调整时是可行的,尤其要注意血流动力学稳定性。

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