经动脉栓塞治疗血流动力学不稳定的脾损伤外伤患者:一项回顾性多中心观察研究。

Naohiro Okada, Hidenori Mitani, Takuya Mori, Masatomo Ueda, Keigo Chosa, Wataru Fukumoto, Kazuki Urata, Ryoichiro Hata, Hajime Okazaki, Masashi Hieda, Kazuo Awai
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引用次数: 0

摘要

目的:我们根据钝性脾损伤患者的血液动力学状态,描述了经动脉栓塞(TAE)治疗的临床结果:这是一项双中心回顾性研究,研究对象为2011年1月至2022年12月期间接受急诊TAE治疗的脾损伤成人患者。患者分为两组:血流动力学不稳定(HDU)患者和血流动力学稳定(HDS)患者。HDU患者被定义为对液体复苏有短暂反应或无反应者,HDS患者被定义为有反应者。如果 HDU 患者无法立即进行开腹手术,则进行血管造影和栓塞治疗。主要结果是出院存活率。此外,还对再出血率和脾切除率进行了调查:结果:38 名因脾脏外伤接受急诊 TAE 的患者中,17 名是 HDU 患者,21 名是 HDS 患者。HDU患者的出院存活率为88.2%(15/17),HDS患者的出院存活率为100%(P = 0.193)。HDU-患者的再出血率为23.5%(4/17),HDS患者为5.0%(1/21)(p = 0.15)。一名 HDU 患者(5.9%)因再出血而需要进行脾切除术:结论:TAE治疗HDU患者脾脏创伤的存活出院率是可以接受的,脾脏切除率较低。为证明TAE的实用性,需要进一步对HDU患者进行TAE与手术治疗的比较研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transarterial embolization to treat hemodynamically unstable trauma patients with splenic injuries: A retrospective multicenter observational study.

Purpose: We described clinical outcomes for patients with blunt splenic injuries treated with transarterial embolization (TAE) based on their hemodynamic status.

Materials and methods: This is a retrospective two-center study of adult patients with splenic injuries who underwent emergency TAE between January 2011 and December 2022. Patients were divided into two groups; hemodynamically unstable (HDU) and hemodynamically stable (HDS) patients. HDU patients were defined as transient- or non-responders to fluid resuscitation and HDS as responders. When immediate laparotomy was not possible for HDU patients, angiography and embolization were performed. The primary outcome was the survival discharge rate. Rebleeding and splenectomy rate was also investigated.

Results: Of 38 patients underwent emergency TAE for splenic trauma, 17 were HDU patients and 21 were HDS patients. The survival discharge rate was 88.2 % (15/17) in the HDU- and 100 % in HDS patients (p = 0.193). Rebleeding rate was 23.5 % (4/17) in HDU- and 5.0 % (1/21) in HDS patients (p = 0.15). Splenectomy was required for one HDU patient (5.9 %) for rebleeding.

Conclusion: The survival discharge rate of TAE for splenic trauma in HDU patients was acceptable with a low rate of splenectomy. Further comparative studies of TAE versus operative management in HDU patients are needed to prove the usefulness of TAE.

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