Clinical characteristics and influencing factors of splenic artery embolization in the treatment of traumatic splenic rupture
Objective To evaluate the clinical efficacy of splenic artery embolization in the treatment of traumatic splenic rupture,and explore the risk factors that affect treatment outcomes and complications.Methods Retrospective analysis was conducted on the clinical data of 63 cases of traumatic closed splenic rupture treated with splenic artery embolization at Taizhou Municipal Hospital and Xiamen Chang Gung Hospital from January 1,2015 to January 1,2022,with their clinical characteristics and factors affecting prognosis analyzed,and predictive models established.Results Among 63 cases of traumatic closed splenic rupture treated with splenic artery embolization,60 cases were successfully rescued,2 cases died,and 1 case underwent laparotomy after interventional surgery,with a success rate of 95.24%.Complications occurred in 15 cases during the treatment process.According to ROC curve analysis,when the injury severity score(ISS)was≥27.5 points,it was most sensitive to the diagnosis of complications,with a sensitivity of 46.70%and a specificity of 77.10%;univariate analysis showed significant differences in the incidence of complications among hemoglobin(Hb),activated partial thromboplastin time(APTT),and American association for the surgery of trauma(AAST)splenic injury scale(P<0.05);multivariate analysis showed that APTT and Hb were independent factors affecting the incidence of complications(P<0.05);the nomogram prediction model showed that the likelihood of complications occurring in APTT>36 s was 17.936-fold higher than that occurring in APTT≤36 s,and the risk of complications in Hb[130,175)g/L was only 6%of that in Hb[70,90)g/L.Conclusion When ISS is≥27.5 points,it is the most sensitive for the diagnosis of complications.Hb,APTT,and AAST are the influencing factors for the occurrence of complications in splenic artery embolization treatment of traumatic splenic rupture,and APTT and Hb levels are independent factors affecting the occurrence of complications.
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