Interventional treatment of hepatic or splenic trauma under the guidance of contrast-enhanced ultrasound:an animal experiment / 中华超声影像学杂志

ABSTRACT

Objective To determine whether hemostatic agents directly injected into injury sites under the guidance of contrast-enhanced ultrasound(CEUS)can effectively control hemorrhage from hepatic or splenic trauma. Methods Healthy adult dogs were impacted by a impactor to create hepatic or splenic trauma. Among 32 dogs,28 had hepatic or splenic injury of grade Ⅲ～Ⅳ according to Injury Scale of the American Association for the Surgery of Trauma(AAST),which were divided into two groups,the treatment group and the control. In the treatment group,hemocoagulase and α-cyanoacrylate were injected respectively into the injury site and transected micro-vessel tinder the guidance of CEUS,while in the control group,normal saline was injected. Results All animals of the two groups survived after the injection. CEUS demonstrated that active hemorrhage disappeared in treatment group but still existed in the control group.In the treatment group,laparotomy showed that hepatic or splenic injury had been covered and adhered with clot and glue membrane of hemostatic agents and free intraperitoneal blood volume was significantly less than that in the control group(P=0.000),while in the control group injury bleeding did not stop after injection. Conclusions Hemostatic agents injected under the guidance of CEUS can effectively control hemorrhage from hepatic or splenic trauma of grade Ⅲ～Ⅳ. This therapy was simple,convenient and effective. It may be performed immediately after hepatic or splenic injury was diagnosed.