妇产科难治性出血超选择动脉插管栓塞治疗临床观察

Clinical observation of superselective arterial embolization for intractable obstetrical and gynecological hemorrhage

目的 :总结 16例严重子宫出血介入栓塞治疗的疗效 ,评价动脉超选择动脉插管栓塞术在妇产科难治性出血治疗中的价值。方法 :采用Seldinger技术对 16例妇产科难治性出血患者 ,经皮股动脉穿刺 ,双髂动脉置管或超选择插管 ,应用数字减影血管造影 (DSA)技术 ,明确出血部位后 ,以明胶海绵颗粒、丝线段或无水酒精栓塞。栓塞后再造影直至靶动脉血流停滞为止。结果 :16例患者中栓塞髂内动脉 6例 ,栓塞子宫动脉 10例 ,均一次栓塞止血成功 ,无 1例并发症 ,随访 3～ 6 9月 ,均无复发及并发症。结论 :应用动脉插管栓塞治疗妇产科难治性出血快捷、彻底、安全可靠、疗效肯定、并发症少 。

Objective:To assess the clinical effects of superselective arterial embolization for intractable obstetrical and gynecological hemorrhage.Methods:Sixteen patients with intractable hemorrhage were treated with arterial embolization. After the target arterials were selected by digital substraction angiography(DSA) , the catheter was inserted into the bilateral internal iliac arteries or uterine arteries using Seldinge's technique.Gelfoam particles mixed with pure alconol were used to embolize the arteries.Results:6 of 16 cases were treated with embolization in internal iliac artery ,and the others in uterus artery. All cases of embolization were successful with one treatment, and no complications occured. Followed up for 3-69 months, no relapse was found.Conclusion:Artery embolization is a safe, rapid and reliable technique for intractable obstetrical and gynecological hemorrhage with less complications.