33例血管性介入治疗在妇产科大出血中的临床应用

33 Cases of Vascular Interventional Treatment of Bleeding in Clinical Obstetrics and Gynecology

目的:探讨妇产科大出血应用血管性介入治疗的效果和临床应用价值。方法:选取在笔者所在医院治疗的妇产科大出血患者33例为研究对象,在数字减影血管造影(DSA)技术支持下对其实施髂内动脉或子宫动脉栓塞治疗方案,总治疗例次为36次。结果:33例患者中,插管失败1例,因严重弥漫性血管内凝血(DIC)而改为接受手术治疗者1例,另有3例患者接受2次介入治疗,其中1例绒癌患者因复发大出血而导致二次介入治疗失败,改由其他方法处理而痊愈。介入治疗过程中止血有效例次为34次,占94.4%;子宫切除2例,占6.1%;一次栓塞止血率达87.9%(29/33)。结论:在妇产科大出血临床类疾病中,血管性介入治疗实施不仅实现了止血效果,并有利于保全患者子宫,且术后随访未出现严重并发症,对女性生理基本无影响,值得在临床上推广应用。

Objective：To investigate the treatment effect and chinical application of clinical obstetrics and gynecology bleeding disorders of vascular interventional.Method：We selected 33 cases of obstetrics and gynecology patients in our hospital as study object,acceptted digital subtraction angiography（DSA） with technical support from the internal iliac artery or uterine artery embolization,a total of 36 cases of treatment.Result：33 cases,intubation failed 1 case,due to severe disseminated intravascular coagulation（DIC） and instead underwent surgery in 1 case,and another 3 cases received two interventions,including 1 case of choriocarcinoma patients recurrent bleeding caused due to secondary intervention failed,replaced by other treatment and recovery.Effective hemostasis during interventional treatment of 34 cases,accounting for 94.4%;Hysterectomy in 2 cases,6.1%;Once embolization rate reached 87.9%（29/33）.Conclusion：The clinical diseases in obstetrics and gynecology hemorrhage,vascular intervention not only to achieve the implementation of hemostasis and help preserve the patients with endometriosis,and postoperative follow-up without serious complications,no effect on female physiology,is worth clinical application.