双侧子宫动脉栓塞治疗在妇产科急性大出血的应用

Bilateral uterine artery embolization therapy in acute bleeding in obstetrics and gynecology

目的：探讨双侧子宫动脉栓塞治疗妇产科急性大出血的应用效果。方法随机选取2013年3月至2015年3月急性大出血患者21例，予以 seldinger 技术的右侧股动脉穿刺，行双侧子宫动脉或髂内动脉栓塞，用明胶海绵颗粒栓塞剂栓塞子宫动脉，恶性肿瘤患者同时予以局部灌注化疗。观察患者治疗后血管造影情况、临床疗效及不良反应情况。结果栓塞治疗后，数字减影血管造影可见子宫动脉及其分支血管均闭塞，肿瘤血管染色消失，且均无造影剂外溢。临床治愈17例（80.95％），有效3例（14.29％），无效1例（4.76％），总有效率为95.24％。结论双侧子宫动脉栓塞术治疗妇产科急性大出血具有止血快、创伤小、疗效显著等特点，且保留了患者的生育功能，可作为妇产科急性大出血治疗的首选方法。

Objective To investigate the effect of the uterine artery embolization on acute bleed-ing in obstetrics and gynecology. Methods Randomly selected 21 cases of bleeding in patients with a-cute hospital from March 2013 to March 2015 ,and conducted seldinger technology right femoral artery puncture,bilateral uterine artery embolization or internal iliac artery,embolization with gelatin sponge particles uterine artery embolization agent. Patients with cancer were given local infusion chemotherapy. After angiography,the clinical efficacy and adverse reactions were observed. Results After emboliza-tion,digital subtraction angiography showed the uterine artery and its branches were occluded blood ves-sels,tumor vessels stain disappears,and no contrast extravasation. Clinical cured in 17 patients （80. 95% ）,effective in 3 cases（14. 29% ）,invalid in 1 patient（4. 76% ）,the total effective rate was 95. 24%（20 cases）. Conclusions Treatment of obstetric and gynecological acute bleeding,uterine ar-tery embolization has bleeding fast,Small trauma,significant effect and other characteristics,and the pa-tient retains the reproductive function,so it can be used as the preferred method for the treatment of acute bleeding in obstetrics and gynecology.