超选择子宫动脉栓塞控制及预防产科出血

Superselective uterine artery embolization for the control and prevention of obstetric hemorrhage

目的探讨超选择子宫动脉栓塞治疗及预防产科出血的应用价值。方法2004年4月-2007年12月共47例产科患者行子宫动脉栓塞术,其中因异位妊娠予终止妊娠者预防性子宫动脉栓塞20例(瘢痕妊娠13例),伴出血者27例(休克2例)。结果所有患者行超选择子宫动脉栓塞,1例因血管解剖因素行单侧栓塞。术后1～10d内行刮宫术或取胚术终止妊娠,术中出血量少,平均54ml。无子宫切除者。结论子宫动脉栓塞为产科出血性疾病提供了成功率高、快速有效的止血方法,预防性应用可减少后期治疗过程中出血。

Objectives To evaluate the efficacy of superseleetive uterine artery embolization for treatment and prevention of obstetric hemorrhage. Methods Between April 2004 and December 2007, 47 consecutive patients underwent uterine artery embolization to control or prevent hemorrhage, including 20 patients for preventing hemorrhage before abortion and 27 for controlling obstetric hemorrhage. Results Bilateral uterine artery embolization was performed in all cases except one for abnormal vascular anatomy receiving unilateral approach. Within 10 clays after embolization, curettage abortion or uterine-incision delivery was clone without hysterectomy, and hemorrhage during abortion was less with average of 54 ml. Conclusions The high success rate, effectiveness and possibility of preserving reproductive function have made uterine artery embolization the technique of choice to control obstetric hemorrhage, and prophylactic embolization, can prevent hemorrhage before abortion.