子宫动脉栓塞在妇产科出血性疾病中的临床应用

Clinical Application of Uterine Artery Embolization for Gynecological Hemorrhagic Diseases

目的:分析妇产科出血性疾病的动脉造影表现,探讨子宫动脉栓塞治疗在妇产科出血性疾病中的疗效及临床应用价值。方法:对38例妇产科出血性疾病的患者,包括产后出血22例,异位妊娠16例,行双侧髂内及子宫动脉造影,并用明胶海绵颗粒对异常血管进行栓塞治疗。结果:38例患者均可见增粗、迂曲的子宫动脉,分支呈螺旋状,25例动脉晚期可见不规则片状染色,16例患者可见对比剂外溢或血管池,未发现卵巢动脉参与供血。所有病例均成功行双侧子宫动脉栓塞术,术后出血立即终止或明显减少,术后血压上升,心率下降,术后1d血压、心率及术后1周血红蛋白与术前比较差异均有统计学意义(P<0.01)。术后至出院期间未发现再次出血情况,未出现严重并发症。结论:子宫动脉栓塞治疗是妇产科出血性疾病安全、有效的治疗方法,具有重要的临床应用价值。

Objective： To analyze the arteriography image of gynecological hemorrhagic diseases and to approach the clinical application value of uterine artery embolization. Methods： Thirty-eight pa- tients with gynecological hemorrhagic diseases, including 22 cases of postpartum hemorrhage and 16 cases of ectopic pregnancy, underwent arteriography of bilateral internal iliac artery and uter- ine artery, and then the abnormal vessels were embolized using spongia gelatinosa. Results： Thickened and sinuous uterine arteries were found in 38 cases, irregular stains in 25 cases, and contrast medium extravasation or vascular pools in 16 eases. The ovarian arteries were uncorre lated with hemorrhage. The bilateral embolization to uterine arteries were successful in 38 cases, which resulted in hemorrhage termination or obvious decrease, blood pressure increasing, and heart rate decreasing immediately. Statistical analysis showed significant changes of blood pres sure, heart rate, and hemoglobin levels after embolization （P〈0.01）. No recurrence of hemor rhage and severe complications were observed in hospital. Conclusion： Uterine artery embolization is a safe and effective method for gynecological hemorrhagic diseases and has very important clinical value.