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  2. 醫療新聞
  3. 女子撞車肝出血 經動脈栓塞術救一命

女子撞車肝出血 經動脈栓塞術救一命

2019/1/10
影像醫學科
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一名女子日前開車不慎自撞電線杆,送醫頻喊膝蓋痛;因她腹部撞到方向盤,中國醫藥大學新竹附設醫院為求謹慎,前後照了兩次腹部超音波,發現她右側肝臟撕裂出血,若未及時處理,肝臟恐被出血擠破、嚴重會引發休克,緊急以微創手術「經動脈栓塞術」止血。醫師指出,肝臟沒有神經不會痛,易被忽略,提醒民眾若腹部受撞擊,須特別注意。

 

中醫大新竹附醫影像醫學科主任阮春榮說,這名輕熟女去年聖誕節當天上午開車出門,不慎自撞電線杆,到院時頻喊膝蓋痛,並表示腹部撞到方向盤,還好繫了安全帶。急診團隊第一次照腹部超音波時,未發現異狀,但因為肝臟沒有神經,急診團隊為求謹慎,在檢查及治療膝蓋後,決定再照一次腹部超音波,發現右側肝臟有不正常腫脹。

 

中醫大新竹附醫影像醫學科主治醫師謝汲峰表示,急診將患者轉至醫學影像科進行電腦斷層、血管攝影,確定有肝臟撕裂傷、內出血現象,因肝臟沒有破裂,因此第一次超音波沒有顯現異狀,但之後肝臟開始緩慢而持續性地出血,若出血量多到擠破肝臟、漫至腹腔,可能引發休克,所幸醫療團隊謹慎照了第二次超音波。

 

謝汲峰指出,患者肝臟血腫最大徑達10公分,出血量約400C.C.,所幸並未撐破肝臟表面;醫療團隊緊急實施「經動脈栓塞術」,不用開刀止血,而是從患者鼠蹊部穿入一根管子直達出血部位,打入栓塞物質止血,傷口僅0.2公分,術後恢復快,第5天即出院。

 

阮春榮指出,「經動脈栓塞術」為醫學中心等級的醫療技術及服務項目之一,適用於內出血,因為傷口小,術後恢復快,以這位病患的傷勢來說,若採傳統手術治療,預估須住院1週以上才能出院,採用微創的「經動脈栓塞術」,傷口小加上患者年輕,大大縮短住院時間。

 

阮春榮提醒,因肝臟沒有神經,疼痛也不會有感覺,常被忽略,等到發現病灶時往往已很嚴重,民眾若是腹部受到大力撞擊,即使沒有嚴重外傷,建議就醫時仍需清楚告知醫師,以免造成更嚴重的後果。

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