超选择性子宫动脉栓塞治疗妇产科大出血

目的:探讨超选择性子宫动脉栓塞治疗妇产科大出血的临床应用价值。方法:12例妇产科大出血患者,其中产后出血5例、人工流产术后出血4例、子宫颈癌2例、子宫肌瘤1例。应用Seldinger技术,行双侧髂内动脉及超选择性子宫动脉造影,应用明胶海绵颗粒栓塞子宫动脉远端,用明胶海绵条或弹簧钢圈栓塞动脉主干。结果:11例妇产科大出血患者,栓塞术后活动性出血立刻停止,3天左右阴道血性分泌物完全消失。1例人流术后大出血病人栓塞后第2天复发而行外科手术。栓塞治疗有效率91.7%。栓塞术后患者仅有轻度发热、腹胀、疼痛,未出现严重并发症。结论:超选择性子宫动脉栓塞治疗妇产科大出血,是一种止血迅速、有效、安全的方法,值得临床推广应用。

Superselective uterial arteries embolization in treating obsteric and gynecologic hemorrhage

Objective: To study the clinical value of superselective uterial arteries embolization in treating obsteric and gynecologic hemorrhage.Methods: Twelve patients with obsteric and gynecologic hemorrhage including postpartum hemorrhage(5 cases),artificial abortion hemorrhage(4 cases),cervix cancer hemorrhage(2 cases),hysteromyoma hemorrhage(1 case).Patients were performed superselective uterial arteries angiography and embolization with gelfoam particles and coil.Results: The bleeding was successfully controlled by embolization in 11 patients.Blood-liking discharge from vagina dispeared about 3 days.Only 1 case artificial abortion hemorrhage failed after embolization,the effective rate was 91.7%.No serious complication happened.Conclusion: The superselective uterial arteries embolization is a rapid,effective and safe therapeutic measure for treatment of obsteric and gynecologic hemorrhage.It should be recommended for wider application.