未经批准:评估2-氰基丙烯酸正丁酯(NBCA)经导管动脉栓塞(TAE)治疗肝硬化患者出血的临床结果。
未经证实:共有35名肝硬化患者(26名男性,9名妇女;平均年龄,对2011年1月至2020年12月因出血而接受NBCATAE的48.4±11.1)患者进行回顾性分析。仅包括在计算机断层扫描(CT)上证实的活动性动脉出血的肝硬化患者。15例患者在栓塞术前血流动力学不稳定,32例患者出现凝血功能障碍。平均MELD评分和ChildPugh评分分别为24±9.9和9.9±2.2。栓塞前输注的平均血红蛋白水平和平均红细胞单位数分别为7.4±1.4g/dL和10.2±4。技术,评估了临床成功率和30日死亡率.
未经评估:在100%和82.8%的患者中实现了技术成功和临床成功率,分别。总体30天死亡率为48%。未发现与栓塞过程相关的主要并发症。只有在栓塞术之前输注的红细胞单位数量较多(OR=1.81,95%CI=1.17-2.80,P=0.007)与临床失败显着相关。更多的RBC单位输注(OR=1.53,95%CI:1.00-2.34,P=0.004)和更高的ChildPugh评分(OR2.44,95%CI1.26-4.71,P=0.008)与更高的30天死亡率显着相关。
UNASSIGNED:使用NBCA的经导管动脉栓塞术可用作肝硬化患者出血的有效治疗选择,尽管肝硬化预后严重,但其技术和临床成功率很高。
UNASSIGNED: To evaluate the clinical outcomes of transcatheter arterial embolization (TAE) with n-butyl-2-cyanoacrylate (NBCA) for treatment of bleeding in cirrhotic patients.
UNASSIGNED: A total of 35 cirrhotic patients (26 men, 9 women; mean age, 48.4 ± 11.1) who underwent TAE with NBCA for bleeding from January 2011 to December 2020 were retrospectively analysed. Only cirrhotic patients with active arterial bleeding confirmed on computed tomography (CT) were included. Fifteen patients were hemodynamically unstable before embolization procedure, and coagulopathy was observed in 32 patients. The mean MELD score and Child Pugh score were 24 ± 9.9 and 9.9 ± 2.2, respectively. The mean haemoglobin level and mean number of RBC units transfused before embolization were 7.4 ± 1.4 g/dL and 10.2 ± 4, respectively. The technical, clinical success rate and 30-day mortality rate were evaluated.
UNASSIGNED: Technical success and clinical success rates were achieved in 100% and 82.8% of patients, respectively. Overall 30-day mortality rate was 48%. No major complications related to the embolization procedure was seen. Only the greater number of RBC units transfused before the embolization procedure (OR = 1.81, 95% CI = 1.17-2.80, P = 0.007) was significantly associated with clinical failure. Greater number of RBC units transfused (OR = 1.53, 95% CI: 1.00-2.34, P = 0.004) and higher Child Pugh score (OR 2.44, 95% CI 1.26-4.71, P = 0.008) were significantly associated with higher 30-day mortality rate.
UNASSIGNED: Transcatheter arterial embolization using NBCA can be used as the effective treatment option for bleeding in cirrhotic patients which has a high technical and clinical success despite the grave prognosis associated with cirrhosis.