摘要
目的:探讨急诊行子宫动脉栓塞(EUAE)治疗产后大出血的临床疗效。方法:65例产后大出血患者行急诊介入造影检查,明确出血部位后,采用丙烯酸微球(TAGM)、明胶海绵颗粒、栓塞弹簧圈及聚乙烯醇(PVA)颗粒对出血动脉行急诊栓塞治疗,对动脉造影表现及治疗效果进行回顾性分析。结果:子宫动脉造影表现:子宫动脉明显增粗,分支迂曲、增多、紊乱43例;子宫动脉造影剂明显外溢27例;假性动脉瘤形成5例,其中左侧2例,右侧3例;由髂外动脉参与供血1例。65例患者经EUAE治疗,62例阴道流血的症状消失,3例仍有阴道流血症状,3例均为胎盘植入,术后行子宫切除。术后随访12个月,62例患者均恢复正常月经周期,未出现严重并发症。结论:双侧子宫动脉造影,对明确诊断出血部位及出血量具有重要意义。EUAE治疗产后大出血是一种创伤小、止血效果确切、无严重的并发症且可保存患者的生育能力的治疗手段。
Objective： To explore the curative effect of emergency uterine artery embolization（ EUAE） on patients with postpartum hemorrhage. Methods： 65 cases of uterine bleeding caused by postpartum hemorrhage underwent emergency arteriography. After bleeding arteries were located,the patients were given embolotherapy with tricacryl gelatin microphere（ TAGM） 、gelatin sponge particles、spring coil and PVA particles. The arteriography manifestations and therapeutic outcome of all 65 patients were retrospectively analysised. Results： Uterine artery angiography manifestations： uterine artery obvious enlargement and branch circuity,increase,disorder were observed in 43 patients;obvious spillover of uterine artery contrast agent were observed in 27 patients; pseudoaneurysm formation were observed in 5 patients： 2 patients on the left and 3 patients on the right,the external iliac artery was involved in 1 patients. After EUAE treatment,the symptoms of vaginal bleeding disappeared in 62 patients,excluding 3 patients with a small amount of hemorrhagic secretions from vagina,all three patients turned out to be implanted placenta and administrated with hysterectomy after EUAE. After 12 months follow-up,62 patients restored to normal menstrual cycle,with no severe complications. Conclusions： Bilateral uterine artery angiography is of great significance for diagnosis the quality and position of bleeding. EUAE is a minimally invasive treatment for postpartum hemorrhage,with definite hemostatic effect,and no serious complications,which can preserve the patient＇s fertility.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2016年第1期66-69,共4页
Journal of Practical Obstetrics and Gynecology
关键词
产后出血
血管造影
子宫动脉
栓塞
Postpartum hemorrhage
Angiography
Uterine artery
Embolization
