血管介入疗法在妇产科疾病治疗中的应用

Application of Vascular Intervention in the Treatment of Obstetric and Gynecological Diseases

【目的】观察血管介入疗法在妇产科疾病治疗中的作用。【方法】对56例异位妊娠、产后大出血、妇科恶性肿瘤伴有急性出血、功血、子宫肌瘤、宫颈肌瘤、子宫肌腺（瘤）病及妇科恶性肿瘤化疗的患者采用Seldinger技术分别行子宫动脉或髂内动脉前干栓塞及持续灌注化疗。【结果】介入治疗异位妊娠能有效杀灭胚胎组织，栓塞破裂血管止血效果明显，且能保持输卵管通畅，减少清宫出血量；产后大出血、功血及妇科恶性肿瘤伴有急性出血者，均在栓塞术后出血立即停止或明显减少；子宫肌瘤、宫颈肌瘤、子宫肌腺（瘤）病者经栓塞治疗，肌（腺）瘤明显缩小，经量减少；宫颈癌患者采取包括介入化疗的综合治疗，近期有效率达81．2％。【结论】介入疗法是有效治疗异位妊娠、产后大出血、子宫肌瘤、宫颈肌瘤、子宫肌腺（瘤）病、功血、妇科恶性肿瘤伴有急性出血及妇科恶性肿瘤的方法之一。

[Objective]To observe the role of vascular interventional therapy for obstetric and gynecological diseases. [Methods]Fifty six cases of ectopic pregnancy, postpartum hemorrhage, gynecological malignant tumors accompanied by acute bleeding, dysfunctional uterine bleeding, uterine fibroids, cervical myorna, myo metrial gland （tumor） disease and gynecological malignant tumors receiving chemotherapy were performed the embolism of uterine artery or anterior trunk of internal iliac artery by Seldinger technique and continuous infusion chemotherapy. [Results]The interventional therapy for ectopic pregnancy effectively killed the embryonic tissue and obviously embolized ruptured blood vessels to stop bleeding, and also maintained tubal patency and reduced the volume of uterine bleeding. After the embolization, the bleeding of patients with postpartum hemorrhage, dysfunctional uterine bleeding and gynecological malignant tumors was halted immediately or de creased significantly. After the patients with uterine myoma, cervical myoma and myometrial gland （tumor） disease received embolism treatment, the size of myoma（adenoma） was significantly reduced and the menstrual volume was decreased. The short-term effective rate of combined therapy including interventional treatment for cervix carcinoma was 81.2%. [Conclusion]The interventional therapy is effective for the treatment of ectopic pregnancy, postpartum hemorrhage, uterine fibroids, cervical myoma, myometrial gland （tumor） disease, dysfunctional uterine bleeding and gynecological malignancies with or without acute bleeding.