摘要
目的 探讨经导管动脉栓塞术 (TAE)在难治性产后出血中的应用价值。方法 以Seldinger技术对 14例难治性产后出血患者 ,行经皮双髂内动脉前干或子宫动脉超选择插管术 ,应用数字减影血管造影 (DSA)技术明确出血部位后灌注抗生素 (头孢噻甲羧肟 ) ,并以明胶海绵颗粒栓塞。结果 (1) 14例经保守治疗无效的难治性产后出血患者 ,经TAE治疗后一次性止血成功 ,止血时间3～ 10min ,平均时间 (6 1± 3 6 )min ,手术时间 30～ 5 0min ,平均 (4 1 8± 6 4)min ;(2 )应用DSA发现 ,出血均来源于单侧或双侧子宫动脉 ,表现为宫腔内弥漫性、局灶性出血或单侧子宫动脉分支出血 ;(3)随访 2～ 6 0个月 ,14例患者均恢复规律月经 ,无严重并发症发生。结论 应用TAE治疗难治性产后出血有较好的临床效果 ,具有止血快。
Objective To assess the value of transcatheter arterial embolization treatment in intractable postpartum hemorrhage. Methods Fourteen patients of postpartum hemorrhage failed to the drugs treatment were performed transcatheter arterial embolization (TAE). Superselective catheterization to the bilateral uterial arteries or anterior branches of internal iliac arteries was carried out after intubation to single side femoral artery by Seldinger′s technique. When the catheter tip was proved in right place by digital substraction angiography (DSA) techniques, antibiotic solution was poured into arteries and then the arterial embolization with gelfoam particles was followed. Results All the patients were performed TAE successfully. The duration of TAE was 30～50 minutes [mean (41 8±6 4) minutes]. Bleeding was found in DSA mostly as diffuse intrauterine flow outward sign from one side or both side of uterial artery branches. After one time of TAE, the vaginal bleeding of all patients was stopped in 3～10 minutes [mean (6 1±3 6) minutes]. The follow up showed that all patients had normal menstrual periods in 2～60 months and no serious complications were found. Conclusion With the characteristic of fast homeostasis and less complications, TAE was proved to be an effective method for intractable postpartum hemorrhage.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2001年第3期133-136,T001,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
栓塞治疗
产后出血
子宫
髂内动脉
吸收性明胶海绵
TAE
Embolization, therapeutic
Postpartum hemorrhage
Uterus
Iliac artery
Gelatin sponge, absorbable
