介入栓塞术在妇产科出血急症中的应用

Application of interventional embolization in acute hemorrhage in department of gynecology and obstetrics

目的：探讨介入栓塞术在妇产科出血急症中的临床疗效和安全性。方法：搜集2011～2013年妇产科急诊出血患者47例,均急诊行双侧髂内动脉造影及选择性动脉栓塞术,观察患者栓塞后的止血效果。结果：全部病例栓塞术后均行双侧髂内动脉造影示双侧子宫动脉及分支血管闭塞未见显影,部分病例髂内动脉前干分支血管闭塞。44例栓塞后出血完全停止;3例栓塞后2天～1周内再次出血,再造影发现部分血管再通及侧支循环开放,再次栓塞出血逐渐停止;均无严重并发症和后遗症。结论：急诊介入动脉栓塞术是治疗妇产科出血急症的一种理想方法,且止血迅速、适应证广泛、安全、并发症少。

Objective： To explore the clinical efficacy and safety of interventional embolization in acute hemorrhage in department of gynecology and obstetrics. Methods： Forty - seven patients with acute hemorrhage in department of gynecology and obstetrics from 2011 to 2013 were collected and treated with emergency bilateral iliae artery angiography and selective arterial embolization, the hemostatic effect was observed. Results ： All the patients were treated with emergency bilateral iliac artery angiography, which indicated no image of bilateral uterine arteries and branch blood vessels, vascular occlusion was found in anterior branches of internal iliac artery in palatial patients ; bleed- ing was stopped completely ＇after embolism in 44 patients ; bleeding occurred again within from two days to one week ＇after embolism in three patients, angiography was pertbrmed again, partial revascularization and collateral circulation open were found, bleeding stopped gradually ＇after embolism again; no serious complication occurred. Conclusion： Emergency interventional artery embolization is an ideal method fur emerger,cy treatment of acute hemorrhage in department of gynecology and obstetrics, which has the advantages of stopping bleeding quickly, wide indications, safety and fewer complications.