目的 探讨医源性肝动脉出血的急诊肝动脉造影表现及经导管动脉栓塞(TAE)治疗的疗效.方法 对38例医源性肝动脉出血患者行急诊肝动脉造影,确定出血动脉后,以明胶海绵、PVA颗粒和弹簧圈进行急诊栓塞治疗；对其急诊肝动脉造影表现及TAE疗效进行回顾性分析.结果 38例中,21例肝动脉造影可见对比剂外溢,5例肝动静脉瘘,9例肝动脉假性动脉瘤,3例肝动脉假性动脉瘤合并肝动静脉瘘.急诊TAE后38例出血均停止,总有效率为100％(38/38).1例术后10天复发出血,再次栓塞治疗后出血停止.随访12个月,所有患者均无肝脏坏死及异位栓塞等严重并发症发生.结论急诊TAE治疗医源性肝动脉出血安全、有效.%Objective To observe the angiographic manifestations,as well as the efficacy of emergency transcatheter arterial embolization (TAE) of iatrogenic hemorrhage of hepatic artery.Methods Emergency angiography of hepatic artery was performed for 38 patients of iatrogenic hemorrhage of hepatic artery.Emergency TAE was conducted using embolic agents such as gelatin sponge,polyvinyl alcohol (PVA) particles and coils as soon as bleeding arteries were identified.The angiographic manifestations and the effect of TAE for iatrogenic hemorrhage of hepatic artery were analyzed retrospectively.Results Contrast extravasation was confirmed in 21 patients,hepatic arterio-venous fistula was detected in 5 patients,pseudoaneurysm of hepatic artery was found in 9 patients,while pseudoaneurysm combined with arteriovenous fistula was seen in 3 patients.Bleeding completely stopped after TAE in all 38 cases,and the total effective rate of emergency TAE was 100％ (38/38).Rebleeding occurred in 1 patient 10 days after the first TAE,but stopped after the second TAE.During 12 months' follow-up,no severe complication occurred.Conclusion Emergency TAE is safe,effective and minimally invasive for the treatment of iatrogenic hemorrhage of hepatic artery.
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