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中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2021, Vol. 09 ›› Issue (01) : 31 -35. doi: 10.3877/cma.j.issn.2095-5782.2021.01.005

所属专题： 文献；

血管介入

胆道大出血的介入诊疗临床价值
鲁东1, 储森林1, 朱义江1, 成德雷1, 柴杰1, 吕维富1,†()   
  1. 1. 230001　安徽合肥，中国科学技术大学附属第一医院（安徽省立医院）介入放射科
  • 收稿日期:2020-09-30 出版日期:2021-02-25
  • 通信作者: 吕维富
  • 基金资助:
    2019年安徽省重点研究与开发计划项目(201904a07020091)

Clinical value of interventional diagnosis and treatment of massive hemobilia

Dong Lu1, Senlin Chu1, Yijiang Zhu1, Delei Cheng1, Jie Chai1, Weifu Lv1,†()   

  1. 1. Department of Interventional Radiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China; Anhui Provincial Hospital, Anhui Hefei 230001, China
  • Received:2020-09-30 Published:2021-02-25
  • Corresponding author: Weifu Lv
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引用本文：

鲁东, 储森林, 朱义江, 成德雷, 柴杰, 吕维富. 胆道大出血的介入诊疗临床价值[J]. 中华介入放射学电子杂志, 2021, 09(01): 31-35.

Dong Lu, Senlin Chu, Yijiang Zhu, Delei Cheng, Jie Chai, Weifu Lv. Clinical value of interventional diagnosis and treatment of massive hemobilia[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(01): 31-35.

目的

探讨胆道大出血介入诊疗临床价值。

方法

收集11例胆道大出血患者的临床资料，分析其出血原因及检查和治疗手段，评估其疗效和安全性。

结果

11例患者中9例为医源性胆道出血，占比达81.82％（9/11）。有胆道手术史者4例，经皮经肝胆道引流（PTBD）术后出血5例，PTBD后肝动脉损伤3例。11例患者中9例在肝动脉数字减影血管造影（DSA）确诊胆道出血后立即行超选择栓塞治疗，止血成功率88.89％（8/9）。11例患者均未出现肝脓肿、肝功能衰竭等严重并发症。

结论

医源性损伤是胆道大出血的主要原因，通过肝动脉造影及栓塞治疗可快速诊断并治疗致命性胆道大出血。

关键词: 胆道大出血, 介入放射学, 栓塞, 诊疗
Objective

To investigate the clinical value of interventional therapy for massive hemobilia.

Methods

The clinical data of 11 patients with massive hemobilia were collected, the causes of the hemobilia were analyzed, examination and treatment methods were analyzed, and the efficacy and safety were evaluated.

Results

Nine of the 11 patients had iatrogenic hemobilia, accounting for 81.82% (9/11). There were 4 cases of biliary surgery, 5 cases of bleeding after PTBD, and 3 cases of hepatic artery injury after PTBD. Among the 11 patients, 9 patients underwent selective embolization immediately after the diagnosis of massive hemobilia by digital subtraction angiography (DSA), and the success rate of hemostasis was 88.89% (8/9). There were no serious complications such as liver abscess and liver failure.

Conclusions

Iatrogenic injury is the main cause of massive hemobilia. Hepatic arteriography and embolization can diagnose and treat the fatal massive hemobilia quickly.

Key words: Massive hemobilia, Interventional radiology, Embolization, Diagnosis and treatment
图1 15岁男性，上腹痛1年余，加重伴呕血1周
图2 70岁男性，胰头癌肝转移胆道粒子支架术后15 d
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