Glubran-2胶用于子宫动脉栓塞治疗产后出血伴凝血功能障碍患者子宫动脉假性动脉瘤

Glubran-2 glue uterine artery embolization for treating uterine artery pseudoaneurysm in postpartum hemorrhage patients complicated with coagulation dysfunction

目的 观察以Glubran-2胶行子宫动脉栓塞(UAE)治疗产后出血伴凝血功能障碍患者子宫动脉假性动脉瘤(UAP)的价值。方法 回顾性纳入13例接受Glubran-2胶UAE治疗的产后出血伴凝血功能障碍UAP患者,包括产后即刻出血8例、迟发性产后出血5例;共17个UAP,其中10例1个、2例2个、1例3个UAP;观察UAE技术成功率、临床治疗成功率、复发率、并发症率、产后恢复月经来潮时间及UAE后生育情况。结果 13例UAE中,11例采用Glubran-2胶联合明胶海绵颗粒进行栓塞、2例单独以Glubran-2胶进行栓塞,Glubran-2胶用量为0.3~2.2 ml/例;UAE技术成功率和临床治疗成功率均为100%。UAE后随访3~75个月,未见严重并发症及复发出血;2例于UAE后2日发热,经抗感染治疗后好转。13例均于产后2~6个月、中位时间4个月恢复月经来潮,且均无再生育意愿。结论 以Glubran-2胶行UAE治疗产后出血伴凝血功能障碍患者UAP安全、有效。

Objective To observe the value of Glubran-2 glue used in uterine artery embolization(UAE)for treating uterine artery pseudoaneurysm(UAP)in postpartum hemorrhage patients complicated with coagulation dysfunction.Methods Data of 13 postpartum hemorrhage patients complicated with coagulation dysfunction who underwent UAE with Glubran-2 glue for treating UAP were retrospectively analyzed,including 8 cases of immediate postpartum hemorrhage and 5 cases of delayed postpartum hemorrhage.There were 17 UAP in 13 cases,including 10 cases with 1,2 cases with 2 and 1 case with 3 UAP.The technical success rate of UAE,clinical success rate,recurrence rate,incidence of complications,first menstrual cycle after childbirth and fertility status after UAE were observed.Results Among 13 cases,11 cases underwent UAE with Glubran-2 glue combined with gelatin sponge particles,while 2 cases underwent UAE with Glubran-2 glue alone.The amount of used glue was 0.3—2.2 ml/case.The technical success rate of UAE and clinical success rate were both 100%.No serious complication nor recurrence of bleeding occurred during the follow-up period of 3—75 months postpartum.Two cases occurred fever 2 days after UAE but alleviated after anti infection treatment.The menstrual cycle restored 2—6 months after UAE,with a median of 4 months.No patient had intention of childbearing again.Conclusion Glubran-2 glue was safe and effective used in UAE for treating UAP in postpartum hemorrhage patients complicated with coagulation dysfunction.