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超声引导下负压吸引、刮宫及经皮引流治疗腹直肌鞘血肿。

Ultrasound-guided suction using negative pressure, curettage, and percutaneous drainage to treat rectus sheath hematoma.

作者信息

Huang Libing, Yi Heng, Liu Weizong, Xiao Zhengkun, Yang Yongheng, Jiang Qian, Li Zhengyi

机构信息

Department of Ultrasound, ShenZhen University General Hospital, 518055, Shenzhen, China.

Department of Ultrasound, General Hospital of the Western War Zone of the Chinese People's Liberation Army 610083, Chengdu, China.

出版信息

Heliyon. 2024 Oct 12;10(20):e39328. doi: 10.1016/j.heliyon.2024.e39328. eCollection 2024 Oct 30.

Abstract

BACKGROUND

This study aimed to introduce and evaluate a new treatment method for rectus sheath hematoma: ultrasound-guided suction using negative pressure, curettage, and percutaneous drainage.

METHODS

This retrospective study involved five patients with rectus sheath hematoma rectus sheath hematoma who had cesarean sections. For all patients, ultrasound revealed that the maximum diameter of their hematoma exceeded 70 mm. We summarized and analyzed the therapeutic effects of five patients and introduced the procedure, technical points, precautions, advantages, and indications of the procedure.

RESULTS

In all five patients, hematoma area was significantly reduced as confirmed by ultrasound at follow-up, and all patients' abdominal pain were significantly relieved. No complications, including bleeding or infection, were detected at both the 2-h postoperative and 3-day follow-up assessments. The hematoma volume reduction rates were 90 %, 67 %, 81 %, 68 %, and 70 % at three days re-examinations, and 99 %, 96 %, 98 %, 98 %, and 90 % at the 30-day follow-up.

CONCLUSION

The removal of rectus sheath hematoma by suction using negative pressure can prevent patients from undergoing abdominal wall exploration, offering a less invasive alternative while potentially achieving comparable therapeutic effect to surgical hematoma removal in certain cases. This treatment method shows potential for clinical application, particularly in relatively young and healthy postpartum women, and is expected to be popularized and applied in clinical practice.

摘要

背景

本研究旨在介绍和评估一种治疗腹直肌鞘血肿的新方法:超声引导下负压抽吸、刮除及经皮引流。

方法

本回顾性研究纳入了5例因剖宫产术后发生腹直肌鞘血肿的患者。所有患者经超声检查显示血肿最大直径均超过70mm。我们总结分析了这5例患者的治疗效果,并介绍了该手术的操作过程、技术要点、注意事项、优点及适应证。

结果

随访超声检查证实,所有5例患者的血肿面积均显著缩小,且所有患者的腹痛均明显缓解。术后2小时及术后3天的随访评估均未发现包括出血或感染在内的并发症。术后3天复查时血肿体积缩小率分别为90%、67%、81%、68%和70%,术后30天随访时分别为99%、96%、98%、98%和90%。

结论

负压抽吸清除腹直肌鞘血肿可避免患者接受腹壁探查,在某些情况下提供了一种侵入性较小的替代方法,同时可能达到与手术清除血肿相当的治疗效果。这种治疗方法具有临床应用潜力,尤其适用于相对年轻健康的产后女性,有望在临床实践中得到推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bcd/11620234/a8d86c51770e/gr1.jpg

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