[1]王 华,于晓河,刘 学,等.胆胰术后迟发性出血介入治疗[J].介入放射学杂志,2020,29(12):1227-1231.
 WANG Hua,YU Xiaohe,LIU Xue,et al.Interventional treatment for delayed postoperative hemorrhage after biliary and pancreatic surgery[J].journal interventional radiology,2020,29(12):1227-1231.
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
29
期数:
2020年12
页码:
1227-1231
栏目:
临床研究
出版日期:
2020-12-25

文章信息/Info

Title:
Interventional treatment for delayed postoperative hemorrhage after biliary and pancreatic surgery
作者:
王 华 于晓河 刘 学 张一军 朱俊军 葛乃建 杨业发
Author(s):
WANG Hua YU Xiaohe LIU Xue ZHANG Yijun ZHU Junjun GE Naijian YANG Yefa.
Section I, Department of Intervention, Oriental Hepatobiliary Surgery Hospital, Naval Military Medical University, Shanghai 201800, China
关键词:
【关键词】 胆胰外科 迟发性出血 介入治疗
文献标志码:
A
摘要:
【摘要】 目的 探讨胆胰术后迟发性出血介入治疗方法、技术和效果。方法 总结海军军医大学东方肝胆外科医院2016年7月至2019年6月期间采用血管内介入术治疗74例胆胰外科术后迟发性出血患者的经验,对比不同介入治疗方法的效果,分析影响患者死亡的因素。结果 74例患者首次血管造影阳性率为90.5%(67/74),血管内介入治疗成功率为98.6%(73/74),死亡率为29.7%(22/74)。死亡主要原因为再出血15例(20.3%)、肝衰竭4例(5.4%)、感染2例(2.7%)、介入操作不成功1例(1.4%)。不同疾病诊断和手术方式间死亡率差异有统计学意义(P<0.05),肝门胆管癌患者死亡率较高。出血类型、出血动脉对术后迟发性出血患者死亡率均无明显影响(P>0.05)。非出血性并发症显著增加患者死亡率(P<0.001)。再出血患者死亡率显著高于无再出血患者(65.2%对12.0%,P<0.001)。覆膜支架植入患者死亡率(26.5%)低于栓塞治疗患者(30.8%),但差异无统计学意义(P>0.05)。 结论 血管内介入术是治疗胆胰术后迟发性出血的有效方法。需合理选择覆膜支架和栓塞方法。减少术后并发症、降低再出血是控制胆胰术后迟发性出血死亡率的关键。

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备注/Memo

备注/Memo:
(收稿日期:2019- 09- 25)
(本文编辑:边 佶)
更新日期/Last Update: 2020-12-16