目的探讨胰周动脉瘤破裂出血的诊治。方法回顾3例胰周动脉瘤破裂出血患者的诊治过程，并结合相关文献进行分析。 结果3例患者胰周动脉瘤破裂出血并失血性休克，其中1例术前经CT检查获得诊断，2例术前未能诊断。2例经手术止血治愈，分别随访1年和1年2个月，未见复发及相关并发症; 1例经抢救无效死亡。结论胰周动脉瘤破裂出血病情发展迅速，术前诊断困难，尽快液体复苏及积极手术探查止血是挽救生命的关键。
ObjectiveTo investigate treatment methods and effect of endovascular interventional therapy for visceral artery aneurysms.MethodsThe clinical data of 32 patients with visceral artery aneurysms, who were treated in the No. 960 Hospital of PLA from February 2011 to April 2018, were retrospectively analyzed. It was proveded by the CT or digital subtraction angiography before the interventional therapy. The implantation of covered stent, coil embolization together with stent implantation, double stents placement or pure coil embolization were performed. The postoperative antithrombotic therapy was adopted in the patients accepted the stent implantation. The CT angiography was performed on the month of 1, 6, 12, 24 or the patient was uncomfortable after the treatment to evaluate the obstruction condition of the aneurysms, stent blood flow, and branches arteries, etc..ResultsThe success rate of the endovascular interventional therapy was 100%. In the 11 patients underwent the implantation of covered stent, the postoperative angiography showed that the stent lumen was patent and the aneurysm was not visualized. In the 9 patients underwent the coil embolization together with stent implantation and 3 patients underwent the double stents placement, the postoperative angiography results of the aneurysm showed that it was faintly visualized and the branch arteries were not involved. In the 9 patients underwent the pure coil embolization, the postoperative angiography showed that the aneurysm was not visualized. No perioperative mortality or procedure related complications occurred. No case was lost during the follow-up of a median period of 25.5 (6–48) months. During the follow-up, one patient developed the mild abdominal pain in one month, which disappeared after the symptomatic medication management. Except for 1 patient developed the mild stent stenosis (<30%) on the 12th month after the procedure, the stent and the branch arteries of the other patients were completely patent, and no aneurysms recurred.ConclusionFor treatment of visceral artery aneurysms, endovascular interventional therapy is safe and effective and shows an excellent short-term and mid-term effects.