产后大出血急诊栓塞治疗的不良反应及并发症探讨

目的:探讨动脉栓塞法治疗急诊产后大出血的不良反应及并发症及其防治。方法:对57例急诊产后大出血患者的双侧子宫动脉或和髂内动脉以及部分患者的卵巢动脉用明胶海绵颗粒进行栓塞。结果:所有病例均出现有栓塞术后综合征;1例患者出现血尿(1.8%);13例患者出现髋部及下肢疼痛、麻木(22.8%);19例患者出现臀部疼痛、红肿、硬结(33.3%);1例患者出现子宫性闭经(1.8%);全组病例未出现子宫坏死或卵巢功能减退等其它严重并发症。结论:产后大出血急诊栓塞治疗会出现一定的不良反应及并发症,在治疗过程中进行超选择性栓塞,不进行过度栓塞,严防栓塞剂返流,可避免大部分严重并发症的发生。

Investigation on the Side Effects and Complications of the Arterial Embolization Therapy for Postpartum Hemorrhage

Objective:To study the side effects and complications of the arterial embolization therapy of postpartum hemorrhage and their prevention and treatment.Methods:Bilateral uterine arteries and/or internal iliac arteries and ovarian arteries in some patients were performed embolization with gelfoam particles on 57 patients suffering from postpartum hemorrhage.Results:All patients had post-embolization symptoms.1 case had bloody urine (1.8%);13 cases had pain and numbness in hip region and lower limbs (22.8%);19 cases had pains and swelling and redness and callosity in gluteal area (33.3%);1 case had uterine amenorrhoea (1.8%);no uterine necrosis and ovarian insufficiency and other serious symptoms were observed.Conclusion:There are some side effects and complications in the arterial embolization therapy for postpartum hemorrhage.Superselective embolization should be adopted,over-embolization and embolization material reflux should be avoided.In this way,most of the serious complications can be avoided.