输尿管动脉栓塞在难治性产后出血介入治疗中的价值

The Value of Ureteral Artery Embolization in Interventional Treatment of Intractable Postpartum Hemorrhage

目的探讨输尿管动脉向子宫供血的特点及其在介入栓塞治疗难治性产后出血中的临床应用价值。资料与方法回顾性分析3例难治性产后出血的盆腔侧支血管数字减影血管造影(DSA)表现及经动脉栓塞(TAE)止血情况。结果3例患者均有输尿管动脉参与子宫供血,其中2例起源于髂外动脉,1例起源于子宫动脉和髂外动脉,将其栓塞后产后出血得到有效控制。结论输尿管动脉是参与子宫供血的重要侧支血管;输尿管动脉参与子宫供血是单纯子宫动脉/髂内动脉栓塞后止血效果不佳的重要原因之一。

Objective To explore the features of ureteral artery supplying to uterine and it＇s clinical values in interventional treatment of intractable postpartum hemorrhage.Materials and Methods DSA data of ureteral arteries supplying to uterine and the branch vessels in 3 cases with intractable postpartum hemorrhage were retrospectively analyzed.Resu-lts Ureteral arteries were showed blood-supply to uterine in 3 cases,and ureteral arteries originated from external in 2 cases,originated from uterine artery and external iliac artery in 1 case.Hemorrhage in 3 cases was completely controlled after ureteral artery embolization.Conclusion Ureteral artery is an important branch vessel supplying to uterine.Ureteral artery supplying to uterine is the main reason of intractable postpartum hemorrhage after internal or uterine artery embolization.