子宫动脉栓塞术在产科出血治疗中的应用

Application of Uterine Arterial Embolization in the Treatment of Obstetric Hemorrhage

目的:探讨子宫动脉栓塞术在治疗胎盘植入等产科出血性疾病中的意义。方法:对20例因胎盘植入等各种病因发生产科大出血的患者,应用Seldinger技术行双侧子宫动脉造影并注入明胶海绵颗粒行栓塞术,其中8例胎盘植入和5例宫颈妊娠者栓塞前先行化疗药物灌注。结果:子宫动脉栓塞术后30 min内阴道流血量显著减少,栓塞术后病人仅表现轻微的疼痛和不同程度的发热,无严重并发症。20例均治愈并保留了生殖功能。结论:子宫动脉灌注栓塞术具有止血迅速、创伤小、并发症及副反应少的特点,且可同时药物灌注,是治疗产科大出血的有效方法。

Objective：To evaluate the significance of uterine arterial embolization（UAE） in the treatment of obstetric hemorrhage.Methods： 20 cases with hemorrhea owing to placenta increta and other obstertrical hemorrhagic disease were treated with bilateral uterine arteriography by Seldinger＇s technique and embolization by inpouring granula of gelatin sponge.Infusion of chemotherapeutics was performed on 8 cases of placenta increta and 5 cases of cervical pregnancy before embolism.Results： The volume of colporrhagia was decreased obviously within 30 min after UAE.These patients complained slight pain and fervescence of various grades,without any serious complications.All patients were cured and their reproductive function was saved.Conclusions： The UAE is a minimally invasive and effective method to treat obstetric hemorrhage.It has advantages of rapid stop bleeding,few of complications and negligible side effects,and moreover could combined with infusion of drugs at the same time.