双侧子宫动脉栓塞术治疗胎盘早剥并发DIC 10例临床分析

Study on bilateral uterine artery embolization in treatment of DIC secondary to severe placental abruption

目的探讨双侧子宫动脉栓塞治疗胎盘早剥并发DIC的可行性和安全性。方法对10例胎盘早剥并发DIC产后出血患者在补充足量凝血因子、抗休克、宫腔塞纱治疗基础上行双侧子宫动脉插管明胶海绵颗粒栓塞。结果10例患者双侧子宫动脉插管均成功,插管成功率100%,平均手术时间(42±5)min,栓塞术平均止血时间(11±3.2)min。10例患者均抢救成功并保留了子宫,无明显近期并发症。结论双侧子宫动脉栓塞治疗胎盘早剥并发DIC产后出血有较好的临床效果,具有止血快,能保留子宫等优点。

Objective To investigate the feasibility, efficacy and safety of bilateral uterine artery embolization （UAE） in treating disseminated intravascular coagulation （DIC） secondary to severe placental abruption. Me thods Based on long gauze stuffing up the uterine cavity, anti - shock therapy and supplement of plentiful coagulation factors, ten patients with DIC secondary to severe placental abruption underwent bilateral uterine artery catheterization and arterial embolization with gelfoam particles. Results Successful catheterization and UAE were achieved in all of the eases. The mean time of the operation was （42±5） min （35±55 min）, and hemostasis was obtained in （11±3. 2） min （5± 15 min） after UAE. No need of hysterectomy and no severe complications occurred in the study. Conclusions UAE can achieve rapid hemostasis so as to preserve uterus. UAE is an effective and safe treatment for DIC secondary to severe placental abruption.