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目的探讨明胶海绵颗粒与Embosphere生物微球栓塞治疗原发性肝癌破裂出血的效果。方法回顾分析近5年来收治的49例(使用明胶海绵23例,使用Embosphere生物微球26例)经导管肝动脉明胶海绵和Embosphere生物微球栓塞治疗的原发性肝癌破裂出血患者的临床资料,评价即时止血和再次出血率。结果明胶海绵组和Embosphere生物微球组即时止血率均为100%;在明胶海绵栓塞治疗后7天内再次出血率为13.0%(3/23),1例转外科手术,1例再次介入治疗,术后成功止血,1例因突发失血性休克死亡;在Embosphere生物微球栓塞后7天内再次出血率为3.8%(1/26),显著低于明胶海绵组(P<0.01)。结论明胶海绵和Embosphere生物微球治疗肝癌破裂出血即时止血效果相同,但Embosphere生物微球治疗术后再出血风险明显减少。
Objective To investigate the effect of gelatin sponge particles and Embosphere bio-microsphere embolization in the treatment of primary liver cancer with ruptured hemorrhage. Methods The clinical data of 49 patients with primary hepatic carcinoma rupture hemorrhage treated by transcatheter hepatic artery gelatin sponge and Embosphere bio-microsphere embolization were retrospectively analyzed in 49 cases (23 with gelatin sponge and 26 with Embosphere) Evaluate immediate hemostasis and rate of rebleeding. Results The rate of immediate hemostasis was 100% in gelatin sponge group and Embosphere biomacromolecule group. The rebleeding rate was 13.0% (3/23) within 7 days after gelatin sponge embolization. One case received surgical operation and the other one received intervention again. One patient died of sudden hemorrhagic shock after successful hemorrhage. The rate of rebleeding was 3.8% (1/26) within 7 days after Embosphere biomacromolecule embolization, which was significantly lower than that of gelatin sponge group (P <0.01). Conclusion The gelatin sponge and Embosphere bio-microspheres have the same effect in the immediate hemostasis of ruptured liver cancer, but the rebleeding risk of Embosphere bio-microspheres is significantly reduced.