PDF(Pubmed)
Abstract：
UNASSIGNED: The diagnostics and treatment management in conditions of massive sanitary losses with the use of staged treatment have their own specifics and require a multidisciplinary approach with the involvement of a wide range of specialists and the use of modern technologies. The number of sources covering the ultrasound diagnostics and clinical course of hepatic artery pseudoaneurysm as a complication of gunshot wounds is quite limited in world literature.
METHODS: We present the experience of the observation and management of the right hepatic artery pseudoaneurysm in case of the blast injury of liver in two patients: the example of successful resolution with spontaneous occlusion and the example with the occurrence of internal bleeding as a result of pseudoaneurysm rupture.
UNASSIGNED: Clinical cases presented here belong to the category of severe injuries caused by high-energy weapons, which are characterized by a syndrome of mutual aggravation and need for simultaneous treatment of several damaged organs. The use of contrast methods in severely injured patients requires instrumental justification, and results of daily ultrasound monitoring with the use of color Doppler program can be the one.
CONCLUSIONS: Pseudoaneurysm of hepatic arteries is a dangerous complication of severe liver wounds and injuries, which occurs in 3·2 % of patients according to our data. The method of ultrasound examination with the use of color Doppler mapping program allows to visualize pseudoaneurysms and monitor their progress. When identifying patients with pseudoaneurysm of hepatic arteries at the level II-III medical care (Role II-III), their further evacuation should be carried out to medical institutions equipped with endovascular correction technologies.
METHODS: We present the experience of the observation and management of the right hepatic artery pseudoaneurysm in case of the blast injury of liver in two patients: the example of successful resolution with spontaneous occlusion and the example with the occurrence of internal bleeding as a result of pseudoaneurysm rupture.
UNASSIGNED: Clinical cases presented here belong to the category of severe injuries caused by high-energy weapons, which are characterized by a syndrome of mutual aggravation and need for simultaneous treatment of several damaged organs. The use of contrast methods in severely injured patients requires instrumental justification, and results of daily ultrasound monitoring with the use of color Doppler program can be the one.
CONCLUSIONS: Pseudoaneurysm of hepatic arteries is a dangerous complication of severe liver wounds and injuries, which occurs in 3·2 % of patients according to our data. The method of ultrasound examination with the use of color Doppler mapping program allows to visualize pseudoaneurysms and monitor their progress. When identifying patients with pseudoaneurysm of hepatic arteries at the level II-III medical care (Role II-III), their further evacuation should be carried out to medical institutions equipped with endovascular correction technologies.
摘要：
■在使用分阶段治疗的情况下，在大规模卫生损失的条件下进行诊断和治疗管理有其自己的特点，并且需要多学科方法，需要广泛的专家参与和使用现代技术。在世界文献中，作为枪伤并发症的肝动脉假性动脉瘤的超声诊断和临床过程的来源数量非常有限。
方法：我们介绍了两名患者在肝脏爆炸伤情况下右肝动脉假性动脉瘤的观察和处理经验：成功解决自发闭塞的例子和由于假性动脉瘤破裂而发生内出血的例子。
■这里介绍的临床病例属于高能武器造成的严重伤害类别，其特征是相互加重的综合征，需要同时治疗几个受损的器官。在严重受伤的患者中使用对比方法需要仪器证明，并且可以使用彩色多普勒程序进行日常超声监测的结果。
结论：肝动脉假性动脉瘤是严重肝脏创伤和损伤的危险并发症，根据我们的数据，这种情况发生在3·2%的患者中。使用彩色多普勒映射程序进行超声检查的方法可以可视化假性动脉瘤并监测其进展。在II-III级医疗保健（角色II-III）中识别肝动脉假性动脉瘤的患者时，应将其进一步撤离到配备血管内矫正技术的医疗机构。
方法：我们介绍了两名患者在肝脏爆炸伤情况下右肝动脉假性动脉瘤的观察和处理经验：成功解决自发闭塞的例子和由于假性动脉瘤破裂而发生内出血的例子。
■这里介绍的临床病例属于高能武器造成的严重伤害类别，其特征是相互加重的综合征，需要同时治疗几个受损的器官。在严重受伤的患者中使用对比方法需要仪器证明，并且可以使用彩色多普勒程序进行日常超声监测的结果。
结论：肝动脉假性动脉瘤是严重肝脏创伤和损伤的危险并发症，根据我们的数据，这种情况发生在3·2%的患者中。使用彩色多普勒映射程序进行超声检查的方法可以可视化假性动脉瘤并监测其进展。在II-III级医疗保健（角色II-III）中识别肝动脉假性动脉瘤的患者时，应将其进一步撤离到配备血管内矫正技术的医疗机构。
