Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta
Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta
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DOI：
10.1097/ta.0000000000000473
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发表时间：
2015-01-01
影响因子：
3.4
通讯作者：
Morita, Hideo
中科院分区：
文献类型：
--
作者：
Ogura, Takayuki;Lefor, Alan T.;Morita, Hideo
背景技术：许多血流动力学稳定的钝性腹部实体器官损伤患者可以成功地进行非手术治疗，而不稳定的患者通常需要紧急剖腹手术。最近，治疗性血管栓塞已被用于治疗血液动力学不稳定患者的腹腔内出血。我们进行了这项研究，审查了一系列血流动力学不稳定的患者腹部实体器官损伤非手术治疗血管栓塞和复苏血管内球囊闭塞的aortico.METHODS：机构审查委员会批准了这项研究。所有患者均通过输血进行适当复苏，并在计算机断层扫描后进行血管造影。复苏血管内球囊闭塞的主动脉进行之前，在所有patients.RESULTS：7例患者进行了复苏血管内球囊闭塞的主动脉严重钝性腹部创伤。28天存活率为86%（6/7）。有没有并发症相关的procedure.CONCLUSION：我们描述了第一个临床系列的血液动力学不稳定的患者腹部实体器官损伤治疗非手术血管栓塞和复苏血管内球囊闭塞的主动脉。生存率为86%，支持需要进一步研究这种方式作为一种辅助的非手术治疗的严重创伤性损伤患者。版权所有（c）2015威科医疗集团All rights reserved.
BACKGROUND: Many hemodynamically stable patients with blunt abdominal solid organ injuries are successfully managed nonoperatively, while unstable patients often require urgent laparotomy. Recently, therapeutic angioembolization has been used in the treatment of intra-abdominal hemorrhage in hemodynamically unstable patients. We undertook this study to review a series of hemodynamically unstable patients with abdominal solid organ injuries managed nonoperatively with angioembolization and resuscitative endovascular balloon occlusion of the aorta.METHODS: The institutional review board approved this study. All patients were appropriately resuscitated with transfusions, and angiography was performed after computed tomography. Resuscitative endovascular balloon occlusion of the aorta was performed before computed tomography in all patients.RESULTS: Seven patients underwent resuscitative endovascular balloon occlusion of the aorta following severe blunt abdominal trauma. The 28-day survival rate was 86% (6 of 7). There were no complications related to the procedure.CONCLUSION: We describe the first clinical series of hemodynamically unstable patients with abdominal solid organ injury treated nonoperatively with angioembolization and resuscitative endovascular balloon occlusion of the aorta. Survival rate was 86%, supporting the need for further study of this modality as an adjunct to the nonoperative management of patients with severe traumatic injuries. Copyright (c) 2015 Wolters Kluwer Health, Inc. All rights reserved.