应用髂内动脉或子宫动脉栓塞治疗产后出血18例

Application of internal iliac or uterine artery embolotherapy for 18 cases of postpartum hemorrhage

目的 探讨应用髂内动脉或子宫动脉栓塞技术治疗产后出血的效果。方法 18例产后出血病例 ,采用Seldinger氏法 ,经皮入一侧股动脉 ,骼内动脉插管造影 ,了解髂内动脉供血区的病变 ,出血部位 ,注入明胶海绵栓塞出血动脉 ,再进行造影 ,证实是否栓塞成功。结果 17例1次栓塞成功 ,1例栓塞后仍因有盆腔内手术残端弥漫性渗血 ,再次剖腹止血 +腹腔引流术后血止。1例术后并发左股动脉血栓形成 ,经再次介入溶栓治疗及抗凝等治疗后痊愈。结论 髂内动脉或子宫动脉栓塞技术是治疗产后出血的一种有效方法。

Objective To explore the effectiveness of internal iliac or uterine artery embolotherapy for postpartum hemorrhage. Methods 18 cases of postpartum hemorrhage were percutaneous put the catheters into one side femoral artery by seldinger's way. Internal iliac artery was taken arteriography to know about pathological changes and bleeding spot of lesion, then poured absorbable gelatin sponge into to embolize bleeding artery and repeated arteriography to verify if embolism succeed. Results 17 cases were successfully performed by primary embolization. One case were successfully performed by secondly transabdominal blocking hemorrhage and abdominal drain .One postoperative case complicated left femoral artery thrombosis was cured by dissolving embolus and anticoagulation. Conclusion The embolism of internal iliac artery or uterine artery is an effective way to treat postpartum hemorrhage.