介入治疗在产科重度出血性疾病中的应用

Application of interventional radiology in the management of severe obstetrical hemorrhage diseases

目的产科重度出血性疾病既往多以切除子宫为最终止血手段。文中探讨介入治疗在产科重度出血性疾病中的应用。方法对2009年1月至2011年11月11例产科重度出血性疾病采用数字减影血管造影(digital subtraction arteri-ography,DSA)介入栓塞治疗,包括前置胎盘4例(其中胎盘植入1例),子宫收缩乏力3例,软产道血肿1例,子宫假性动脉瘤1例,剖宫产术后子宫切口愈合不良1例,以及1例因"胎盘植入"外院行次全子宫切除术后创面渗血1例。结果 11例患者均抢救成功,无明显并发症。结论介入治疗为产科重度出血性疾病开创了一条新途径。

Objective Hysterectomy used to be the last resort of stopping bleeding in severe obstetrical hemorrhage diseases.This article is to investigate the application value of interventional radiology in the management of severe obstetrical hemorrhage diseases.Methods We employed digital subtraction arteriography（DSA） intervention embolism techniques in the treatment of 11 patients with severe obstetrical hemorrhage diseases,including 4 cases of placenta previa（including 1 case of placenta increta）,3 cases of uterine atony,1 case of soft birth canal hematoma,1 case of uterine artery pseudoaneurysm,1 case of poor healing of uterine incision after cesarean section and 1 case of intra-abdominal hemorrhage that had received subtotal hysterectomy in the local hospital for placenta increta.Results All the 11 cases were managed successfully with no obvious complications.Conclusion Interventional radiology has provided a new way for the treatment of severe obstetrical hemorrhage diseases.