腰动脉栓塞治疗经皮椎间孔镜引起的大出血4例.docxVIP

腰动脉栓塞治疗经皮椎间孔镜引起的大 出血4例 陈水兵虞希祥 温州医科大学附属第二医院、育英儿童医院介入科 温州市人民医院介入血管外科 摘要： 目的探讨腰动脉栓塞治疗经皮椎间孔镜术(PTED)引起的大出血的疗效及安全 性。方法对4例PTED引起的大出血患者行腰动脉造影，根据腰动脉造影情况，以 微粒和弹簧圈进行栓塞治疗。结果3例患者腰动脉造影可见对比剂外溢，1例患 者腰动脉造影可见假性动脉瘤。4例患者腰动脉栓塞后出血完全停止，随访T 个月均无再次出血及严重并发症发生。结论PTED引起的大出血内科和外科处理 都比较困难，腰动脉栓塞治疗PTED引起的大出血安全、有效、微创，值得借鉴 和推广。 关键词： 经皮椎间孔镜;岀血;腰动脉;栓寒; 作者简介：虞希祥E-mail:yudsa@126. com 收稿日期：2017-05-02 Lumbar artery embolization for the treatment of massive hemorrhage caused by percutaneous transforaminal endoscopic discectomy: preliminary experience in 4 patients CHEN Shuibing YU Xixiang Departmer^Lof Interventional Radiology, Second Aff订iated Hospitol and Yuying Ch订drens Hospital, Wenzhou Medical University; Abstract： Objective To evaluate the curative effect and safety of lumbar artery embolization in treating massive hemorrhage caused by percutaneous transforamineil endoscopic disccctomy (PTED) . Methods From January 2013 to December 2016, lumbar artery angiography was performed in 4 patients with massive hemorrhage caused by PTED. Based on the angiographic findings, lumbar artery embolization therapy with embolic microspheres and spring coi1s was carried out. Results Lumbar artery angiography revealed that extravasation of contrast agent was dctcctcd in 3 patients and pseudoaneurysm in one patient. The bleeding completely stopped immediately after lumbar artery embolization in all 4 patients. The patients were followed up for 1-3 months, and no re-bleeding or serious complications occurred. Conclusion It is very difficult to make medical and surgical management for massive hemorrhage caused by PTED. Lumbar artery embolization is safe, effective and minimally-invasive for the treatment of massive hemorrhage caused by PTED. This therapy is worthy of cl inical use. Keyword： pcrcutaneous tronsforeuninal cndoscopic discectomy; hemorrhage; lumber artery; embolization; Received： 2017-05-02 近年来，随着微创医学的进步，经皮椎间孔镜术(percutaneous transforaminal endoscopic discectomy, PTED)治疗腰椎间盘突出症的应用越 來越广，并取得良好的疗效上红。虽然PTED引起的大出血