剖宫产术后晚期出血的原因探讨及介入治疗价值

The reason of late hemorrhage after cesarean section and the value of interventional therapy

目的通过DSA探讨剖宫产术后晚期出血的原因及介入治疗价值。方法对5例剖宫产术后晚期出血患者行双侧子宫动脉造影及介入栓塞治疗。结果5例患者中,3例造影表现为假性动脉瘤形成,其中1例合并动静脉瘘。2例表现为切口处血管出血。5例患者经介入栓塞治疗后均取得满意止血效果,术后随访均无再次出血。结论血管造影可以明确剖宫产术后晚期出血的原因。介入栓塞治疗剖宫产术后晚期出血具有疗效快,安全性高,损伤小,易为患者接受等优点。

Objective To investigate the causes of late hemorrhage after cesarean section and the value ofinterventional therapy.Methods： Five cases of late hemorrhage after cesarean section received bilateral uterine artery angiography and embolization. Results： Angiographies demonstrated pseudoaneurysm in 3 patients, arteriovenous fistula in 1 case, and vascular incision bleeding in 2 cases. The embolization treatment of 5 patients achieved satisfactory hemostasis, andpostoperative follow-up showed no further bleeding. Conclusions： Angiography can showe the causes of late hemorrhage after cesarean section. Embolization has a good efficacy and it is a safety treatment of bleeding caused by cesarean section which easily accepted by patients.