摘要
目的探讨急诊子宫动脉栓塞(UAE)治疗产后胎盘植入大出血的方法和疗效。资料与方法在数字减影机下采用改良式Seldinger技术对7例胎盘植入患者穿刺插管行盆腔动脉造影,明确出血血管后将5FCobra导管超选择插入出血侧子宫动脉,立即用明胶海绵颗粒和明胶海绵条栓塞。术后肌注甲氨喋呤并口服米非司酮各一个疗程。结果 7例胎盘植入患者均找到出血位置并一次性栓塞成功,成功率100%。手术时间25～50min,平均(35.2±5.3)min,术后3～12min阴道流血停止,平均(5.2±2.4)min,术后患者血压迅速回升至正常,生命体征稳定。术后1天～4周6例排出胎盘组织,平均排出时间15.4天,子宫如期复旧,血绒毛膜促性腺激素(β-HCG)恢复正常,跟踪随访月经正常,自测排卵正常。结论急诊UAE治疗胎盘植入大出血具有手术时间短、创伤小、疗效肯定和可保留子宫等优点,有较好的临床应用价值。
Objective To explore the curative effect of uterine artery embolization for treatment of post partum hemorrhage due to placenta increta.Materials and Methods By means of seldinger technique,pelvicarteriography was performed to confirm bleeding vessel.then a 5F Cobra catheter was inserted into uterine artery,and gelfoam was injected for superselective embolization immediately.Intramuscular injections of MTX and take orally mifepristone were needed after operation.Results In 7 cases of placenta increta,bleeding vessels were all confirmed and successfully embolism with the success rate of 100%.The operation time ranged from 25 to 50 minutes and the mean time was 35.2 ± 5.3 minutes.Vaginal bleeding continued for 3 to 12 minutes after operation and the mean time was 5.2 ± 2.4 minutes.Normal Blood pressure recovered after operation and vital signs was stable.Six cases of placenta discharged at one day to the 4th week after operation,and the mean time was 15.4 d,at the same time,the uterus and β-HCG of blood recovered.The follow-up menstruation and ovulation were nomal.Conclusion Uterine artery embolization for post partum hemorrhage with the superiorities of short operation time,minimal invasion,good curative effect,has high value of clinical application.
出处
《临床放射学杂志》
CSCD
北大核心
2010年第7期951-954,共4页
Journal of Clinical Radiology
关键词
栓塞
胎盘植入
治疗性
产科大出血
Embolization Placenta increta Therapeutic Massive postpartum hemorrhage
作者简介
通讯作者
