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中华介入放射学电子杂志 ›› 2023, Vol. 11 ›› Issue (02) : 193 -196. doi: 10.3877/cma.j.issn.2095-5782.2023.02.018

所属专题: 经典病例

病例报告

医源性损伤致肋间动脉破裂出血介入治疗2例
林志鹏1, 胡小龙1, 邹旭公1, 黄大钡1, 陈源1, 李晓群1, 张健1,()   
  1. 1. 528499 广东中山,中山市人民医院介入医学科
  • 收稿日期:2022-06-25 出版日期:2023-05-25
  • 通信作者: 张健

Interventional treatment of intercostal artery rupture caused by iatrogenic injury:two cases report

Zhipeng Lin1, Xiaolong Hu1, Xugong Zou1   

  • Received:2022-06-25 Published:2023-05-25
引用本文:

林志鹏, 胡小龙, 邹旭公, 黄大钡, 陈源, 李晓群, 张健. 医源性损伤致肋间动脉破裂出血介入治疗2例[J]. 中华介入放射学电子杂志, 2023, 11(02): 193-196.

Zhipeng Lin, Xiaolong Hu, Xugong Zou. Interventional treatment of intercostal artery rupture caused by iatrogenic injury:two cases report[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(02): 193-196.

胸腔穿刺术主要用于胸腔积液诊断和气胸、胸腔积液的治疗,该手术操作的典型并发症包括气胸、出血(包括血胸)和复张性肺水肿[1]。胸腔穿刺引起肋间动脉损伤造成大出血为罕见的并发症;文献中报道的医源性损伤病例相对较少,既往的报道主要为外科手术的并发症[2]。对肋间动脉大出血的及时处理很重要,我们将2例胸腔穿刺术致肋间动脉大出血成功行介入止血(1例明胶海绵栓塞及1例弹簧圈栓塞)的病例报道如下。

图1 病例1患者诊治过程1A:治疗期间出现单侧胸腔积液(右侧),遂行右侧胸腔积液诊断性穿刺送检化验;1B:床边B超提示右侧胸腔积液明显增加,积液最大厚度11.3 cm;1C:右侧第7肋间动脉选择性造影可见造影剂外溢;1D:弹簧圈栓塞后右侧第7肋间动脉可见造影剂停滞,未见造影剂外溢;1E:术后复查胸部CT,胸腔积液无明显增加。
图2 病例2患者诊治过程2A:入院时存在双侧胸腔积液,行双侧胸腔穿刺置管引流术;2B:拔出胸腔引流管后患者突发血压下降,复查CT可见右侧胸腔积液增多;2C:床边胸片可见右侧胸腔积液增加;2D:右侧第7肋间动脉选择性造影可见造影剂外溢;2E:明胶海绵(350~560 μm)栓塞后右侧第7肋间动脉可见造影剂停滞,未见造影剂外溢;2F:术后复查胸部CT,胸腔积液较前减少。
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