栓塞微球联合弹簧圈栓塞治疗产后出血的疗效

Embolization Microspheres Combined with Spring Coils for Postpartum Hemorrhage

目的探讨栓塞微球联合弹簧圈栓塞治疗产后出血的临床疗效。方法将80例患者按不同的栓塞方式分为试验组和对照组,每组40例。2组均行双侧子宫动脉栓塞术,试验组术中采用5F导管联合栓塞微球、弹簧圈栓塞,对照组术中采用5F导管联合明胶海绵颗粒、明胶海绵条栓塞。观察2组术中、术后并发症及临床疗效。2组随访4~68个月。结果试验组总有效率明显高于对照组（P〈0.05）。2组术中、术后均出现不同程度下腹部疼痛、恶心呕吐,经止痛、止吐等处理,2~3d自行缓解;2组均未出现宫腔感染、子宫坏死和破裂、髋部疼痛、下肢麻木及感觉过敏等严重并发症。随访4~68个月,试验组4例、对照组2例出现经期延长、经量增多,未作特殊处理,恢复正常;试验组2例、对照组1例出现闭经,3例均未出现潮热、易怒、情绪低落、记忆力减退等症状,女性激素水平正常,均未行人工周期治疗。结论栓塞微球联合弹簧圈治疗产后出血止血效果确切,并发症少,应作为保守治疗无效的产后出血的首选治疗方法。

Objective To investigate the curative effect of embolization microspheres combined with spring coils on postpartum hemorrhage.Methods According to different ways of embolization,80 patients were divided into two groups,with 40 patients in each group.Bilateral uterine artery embolization was performed with 5Fcatheters combined with embolization microspheres and spring coils in experimental group,and with 5Fcatheters combined with gelatin sponge particles and strips in control groups.Patients were followed up for 4-68 months,and the intraoperative and postoperative complications and clinical efficacies were observed.Results The total effective rate in experimental group was significantly higher than that in control group（P〈0.05）.Patients in both groups had different degrees of abdominal pain,nausea and vomiting,which were relieved2-3days after anti-pain and anti-nausea treatment.No patients had intrauterine infection,uterine necrosis and rupture,hip pain,lower limb numbness,hyperesthesia,and other serious complications.During the follow-up period,4patients in experiment group and 2patients in control group had prolonged menstruation and increased menstrual volume,which restored to normal after conventional treatment.In addition,2patients in experimental group and 1patient in control group had amenorrhea.The hot flash,irritability,depression,hypomnesis and other symptoms were not found in 3patients in control group.Female hormone levels were normal and no artificial cycle treatments were performed in these patients.Conclusion The combination of embolization microspheres and spring coils is effective and leads to few complications in the treatment of postpartum hemorrhage.Therefore,it should be used as the preferred treatment for postpartum hemorrhage after invalid conservative therapy.