双侧子宫动脉栓塞治疗产后大出血15例

Uterine artery embolization in 15 cases of postpartum hemorrhage

目的:探讨双侧子宫动脉栓塞治疗产后大出血的应用价值。方法:对15例产后大出血患者实施经皮双侧子宫动脉插管,通过数字减影血管造影(DSA)明确出血部位,用明胶海绵超选择栓塞双侧子宫动脉,其中2例使用微钢圈栓塞。结果:出血均来源于单侧或双侧子宫动脉,造影剂呈片状、小点状外渗,或子宫动脉明显扭曲;用明胶海绵颗粒或加上微钢圈栓塞后即作DSA造影显示子宫动脉已栓塞,造影剂无外渗,出血立即完全停止13例,逐渐减少2例,经对症治疗1周内出血停止。结论:双侧子宫动脉介入栓塞治疗产后大出血是快速、有效、微创、操作简便的治疗方法。

Objective：To evaluate the value of uterine artery embolization in treating postpartum hemorrhage.Methods：Fifteen cases with postpartum hematorrhea were treated by Seldinger catheterization of uterine arteries,and the uterine arteries were embolized super selectively by gelatin sponge after the hemorrhagic site were found by digital subtraction angiography（DSA）.Some bleeding patients were also operated by micro-wheel embolism.Results：Uterine artery angiography showed that uterine artery had been embolized and no extravasation of contrast agent.The hemorrhage came from one side or double sides of uterine artery as diffused or focal uterine cavity bleeding or branch bleeding of uterinecavity or significantly distorted uterine artery.DSA angiography showed that the bleeding of 13 cases were ceased completely after embolism while the others were decreased obviously and gradually ceased within one week after drug treatment.Conclusions：The method of using the uterine artery embolization to treat the postpartum hematorrhea has many advantages which stopping bleeding quickly,effective,suffering lightly with few complications.