动脉栓塞治疗难治性产后出血6例分析

目的 :探讨动脉栓塞治疗难治性产后出血的临床价值。方法 :用Seldinger技术对 6例难治性产后出血患者行经皮髂内动脉或子宫动脉超选择插管术 ,通过数字减影血管造影 (DSA)明确盆腔血管走向及造影剂外溢情况后 ,双侧分别注入明胶海绵条栓塞。结果 :6例插管栓塞均 1次成功 ,手术时间短 ,止血速度快 ,并且保留子宫及其生理功能。其中 2例术后再次生育。但 1例术后发生右下肢动脉血栓形成 ,手术取栓后愈合。结论 :动脉栓塞术治疗难治性产后出血快速 ,有效 ,安全 ,并保留了子宫。

Treatment of Intractable Postpartum Hemorrhage by Embolizing Artery: A Report of 6 Cases

Objective: To evaluate the clinical value of embolizing artery in the treatment of intractable postpartum hemorrhage. Methods: 6 patients of intractable postpartum hemorrhage were performed transcatheter arterial embolization (TAE). Superselective catheterization in the bilateral uterine arteries or internal iliac arteries was carried out after intubating to single-side femoral artery by Seldinger's technique. When the catheter tip was proved in right position and the pelvic blood vessels were showed by digital subtraction angiography(DSA) techniques, the arterial embolization with gelfoam particles was followed. Results :The operation of all the patients were successfully performed at one time, the operative time was short, and postpartum hemorrhage ceased immediately. These patients' uterus and their physiological function were reserved. Only one case occurred serious complications with thrombosis in her right lower extremities after TAE and was recovery soon after operation. Conclusions: The treatment of intractable postpartum hemorrhage by embolizing artery was proved to be an effective, fast, and safe method, and the uterus can be reserved.