探讨介入性血管栓塞治疗外伤性肝脾破裂出血患者中的优越性，评价其临床应用价值。

随机对照研究深圳市宝安区福永人民医院2010年5月至2016年5月收治的82例外伤性肝脾破裂出血患者男性49例，女性33例；年龄18～55岁，平均年龄(32.5±4.5)岁。按照随机数字法将患者分为介入栓塞组和手术治疗组，每组各41例。在常规基础治疗的基础上，介入栓塞组患者接受介入性血管栓塞术治疗，手术治疗组患者则接受外科手术治疗。术后对比观察两组患者手术时间、术中出血量、住院时间、血清谷丙转氨酶(ALT)水平、开始进食时间、一次性止血成功率和术后不良反应(再出血、感染、发热)发生率的差异。

两组患者手术时间差异无统计学意义(P>0.05)。与手术治疗组相比，介入栓塞组患者术中出血量少[(65.98±10.56)mL vs(354.74±20.47)mL]，住院时间和开始进食时间短[(6.98±2.45)d vs(12.78±4.68)d；(3.24±0.75)d vs(6.74±2.47)d]，血清ALT水平高[(43.46±6.95)U/L vs(23.28±5.43)U/L]，一次性止血成功率高[100%(41/41)vs 85.36%(35/41)]且术后不良反应发生率低[4.88%(2/41)vs 24.39%(10/41)]，差异有统计学意义(P均<0.05)。

介入性血管栓塞技术治疗外伤性肝脾破裂出血具有手术创伤小、术后并发症发生率低、疗效确切、安全性高等优点，值得临床推广。

To explore the advantages of interventional vascular embolization in the treatment of traumatic hepatic and spleen rupture and to evaluate its clinical value.

Randomized controlled 82 cases of traumatic patients with liver and spleen rupture in Shenzhen Baoan District Fuyong People’s Hospital from May 2010to May 2016, Including 49 males and 33 females, aged 18 to 55 years, mean age was (32.5±4.5) years. According to the random number rule, the patients were divided into interventional embolization group and surgical treatment group, 41 cases in each group. On the basis of conventional basic therapy, patients undergoing interventional embolization were treated with vascular interventional vascular embolization, and patients in the surgical treatment group received surgical treatment. After surgery, Comparison of differences about Operation time, intraoperative blood loss, hospitalization time, serum alanine aminotransferase (ALT) level, time to start eating, the success rate of one-time hemostasis and the incidence of adverse reactions (rebleeding, infection, fever) so on.

There was no significant difference in the operation time between the two groups (P>0.05). Compared with the surgical treatment group, Interventional embolization in patients with less bleeding[(65.98±10.56)mL vs(354.74±20.47)mL], shorter hospital stay and start eating time[(6.98±2.45)d vs(12.78±4.68)d; (3.24±0.75)d vs(6.74±2.47)d], high serum ALT levels[(43.46±6.95)U/L vs(23.28±5.43)U/L], high success rate of one-time hemostasis[100%(41/41)vs 85.36%(35/41)], adverse reaction rate was low[4.88%(2/41)vs 24.39%(10/41)], the difference was statistically significant (P<0.05).

Interventional vascular embolization is a safe and effective treatment for patients with traumatic hepatic and splenic rupture. It is worthy to be popularized because of its advantages such as less operative trauma, less complication rate, better curative effect, and higher safety.