子宫动脉栓塞术所致严重并发症的思考

Thinking about the serious complications of uterine arterial embolization

子宫动脉栓塞术是妇产科放射介入治疗的一个核心技术。应用于子宫恶性肿瘤、重度产后出血、子宫肌瘤、子宫腺肌病等多种妇科疾病治疗中,取得良好的临床效果。但同时临床上也有各种栓塞并发症的报道,有些严重并发症甚至可致残、致死。常见的严重并发症包括闭经、子宫严重感染坏死、输尿管损伤、膀胱坏死、下肢肢体坏死、肺动脉栓塞和神经损伤。合理选择子宫动脉栓塞术适应证及栓塞剂,栓塞时注意置管到位避免误栓及栓塞剂反流是避免严重并发症发生的关键。

Uterine arterial embolization （UAE） is a key technique of intervention treatment for gynecologic and obstetric diseases. It has been used in many gynecologic and obstetric diseases such as malignant uterine neoplasm,postpartum massive hemorrhage, uterine fibroids and adenomomyosis, and has achieved good clinical efficacy. At the same time, we found some reports on many kinds of complications after UAE, and some of them were very serious and even could lead to deformity or death. These severe complications included amenorrhea, severe inflammation and necrosis of uteru, vesicoureteral injury, gangrene of bladder, necrosis of lower extremity, acute pulmonary embolism and nerve injury. Selecting right emobolizing agent for right patients in UAE, paying more attention to the location of interventional catheter and avoiding misemoblization when managing UAE can lower the occurrence of severe complications.