대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제78권2호
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  • Pages.120-129
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  • 2018
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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혈종형성에 대한 경동맥색전술: 원인과 임상적 결과로 분류한 그룹에 대한 분석

Transcatheter Arterial Embolization for Acute Arterial Extravasation with Hematoma Formation: Classified the Group as Cause and Their Clinical Outcomes

  • 김보람 (전북대학교 의학전문대학원 전북대학교병원 영상의학과) ;
  • 한영민 (전북대학교 의학전문대학원 전북대학교병원 영상의학과) ;
  • 진공용 (전북대학교 의학전문대학원 전북대학교병원 영상의학과)
  • Kim, Boram (Department of Radiology, Chonbuk National University Medical School and Hospital) ;
  • Han, Young Min (Department of Radiology, Chonbuk National University Medical School and Hospital) ;
  • Jin, Gong Yong (Department of Radiology, Chonbuk National University Medical School and Hospital)
  • 투고 : 2017.04.30
  • 심사 : 2017.07.11
  • 발행 : 2018.02.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 혈종형성을 동반한 급성동맥출혈 환자에서 출혈의 원인별로 관련된 유의한 인자와, 임상적 결과에 따른 위험인자를 분석하고자 하였다. 대상과 방법: 2007년 4월부터 2014년 12월까지 급성동맥출혈로 경동맥색전술을 시행한 환자 50명(남자: 24, 여자 36, 평균연령: 63.8세)을 대상으로 연구하였다. 출혈 원인에 따라 자발성 출혈군과, 외상에 의한 출혈군, 의원성 출혈군으로 분류하였다. 세 군에서 성별, 연령, 혈종의 크기와 액화의 유무, 전산화단층촬영상 혈관 외 유출의 여부, 유출을 보이는 동맥의 개수, 출혈부터 시술시작까지의 시간, 색전물질, 입원일수를 비교 분석하였다. 결과: 모든 색전술은 성공적으로 시행하였다. 자발성 출혈군은 약 36%(18/50)였으며, 외상에 의한 출혈군은 42%(21/50), 의원성 출혈군은 22%(11/50)였다. Mann Whitney U test에서는 자발성 출혈군에서 국제정상화비율(p = 0.013)이, 외상성 출혈군에서는 국제정상화비율(p = 0.038)과 혈소판(p = 0.004)이 출혈군별로 유의한 차이를 보였다. 역시, 임상적 성공에 영향을 미치는 요인으로는 혈소판(p = 0.046)이 있었다. 결론: 혈종형성을 동반한 급성동맥출혈환자에서 경동맥색전술은 안전하고 효과적인 치료이며, 출혈 원인을 고려하여 관련된 인자를 알고 적합한 치료방향을 선택해야 한다.

Purpose: To present our experience in transcatheter arterial embolization (TAE) for hematoma formation related to variable causes. We analyzed the factors that could affect clinical outcomes. Materials and Methods: A retrospective study was conducted on 50 patients (24 men, 36 women; mean age, 63.8 years) who were treated for a TAE to control bleeding. Computed tomography (CT) scans showed the formation of hematomas. We classified the patients into three groups depending on the underlying cause of the hematoma i.e., spontaneous, traumatic or iatrogenic groups. We evaluated relevant factors such as sex, age, hematoma size and liquefaction, extravasation on CT, injured artery, onset to procedure time, embolization material, hospital day. Results: TAE was successfully performed in all patients. The proportions of patients in the spontaneous, traumatic, and iatrogenic bleeding groups were 36% (18/50), 42% (21/50), and 22% (11/50), respectively. Using the Mann Whitney U test, the international normalized ratio (INR) was statistically different for the spontaneous bleeding group (p = 0.013). In addition, the INR (p = 0.038) and platelet count (p = 0.004) were significant different for the traumatic group. Also, the platelet counts were related to clinical successes (p = 0.046). Conclusion: Based our experience, TAE is a safe and effective treatment option for the management of hematoma formation. Furthermore, the interventional radiologist should consider the cause of hematoma formation in order to perform proper treatment.

키워드

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