子宫动脉栓塞术治疗剖宫产后疤痕妊娠大出血19例临床疗效

Efficacy of uterine artery embolization in treating massive hemorrhage after Cesarean section in patients with scar pregnancy

目的探讨剖宫产后子宫疤痕妊娠大出血急诊双侧子宫动脉栓塞术的应用价值。方法 19例剖宫产后大出血患者,DSA监视下以Seldinger技术先行猪尾巴导管腹主动脉照影,明确双侧子宫动脉出血后行选择性插管,经导管于双侧子宫动脉内注入MTX和明胶海绵颗粒栓塞。结果 19例大出血患者全部栓塞成功,随访3～6个月无再次大出血。结论双侧子宫动脉化疗栓塞术治疗子宫大出血成功率高,损伤小,操作简便,并发症少。

Objective To investigate the efficacy of uterine artery embolization in treating acute massive hemorrhage after Cesarean section in patients with scar pregnancy massive hemorrhage after Cesarean section.Methods Selective embolization of the uterine arteres with MTX gelatin sponge particles was performed in 19 cases with massive bleeding after Cesarean section of scar pregnancy.The super-selective insertion of pigtail catheter into bilateral uterine arteries with Seldinger technique was carried out under DSA imaging and MTX gelatin sponge particles were injected.Results The selective embolization of the uterine arteres was all successful in 19 cases with acute massive hemorrhage after Cesarean section of scar pregnancy.There was no rebleeding during follow up for 3 to 6 months.Conclusion Bilateral embolization of uterine arteries with MTX gelatin sponge particles is effective in treating acute uterine hemorrhage with the advantages of minimal invasion,simple practice and less complications.