产后大出血急诊介入治疗临床疗效观察

目的：评价利用经导管动脉栓塞术(transcatheter arterial embolization，TAE)急诊治疗产后大出血的临床疗效。方法：对10例产后大出血患者实施急诊经皮双侧髂内动脉前干插管术，通过数字减影血管造影（DSA）明确出血部位，超选择性用明胶海绵栓塞子宫动脉。结果：DSA显示出血均来源于单侧或双侧子宫动脉，表现为造影剂在宫腔内呈弥漫性，局灶性分布。栓塞后8例出血完全停止；2例出血明显减少，经药物对症治疗后一周内出血逐渐停止，未发生严重并发症。结论：应用急诊动脉栓塞术治疗产后大出血有良好的临床效果，具有止血迅速，疗效可靠，创伤小，并发症少的特点，并可达到保留子宫的目的。

Observation of Clinical Effect on Using Emergency Intervention Treatment in Postpartum Hematorrhea

Purpose To evaluate the clinical effect on using transcatheter arterial embolization (TAE) in treating postpartum hematorrhea. Methods Ten cases with postpartum hematorrhea were treated emergently by Seldinger catheterization of internal iliac artery,and the uterine arteries were embolized super selectively by gelatin sponge after the hemorrhagic site were found by DSA. Results DSA angiography showed that the hemorrhage came from one side or double sides of uterine artery as diffused or focal uterine cavity bleeding or branch bleeding of uterine cavity.The bleeding of 8 cases were ceased completely after embolism while the others' were decreased obviously and gradually ceased within a week after drug treatment.All the cases had no serious complications. Conclusion Using the emergently uterine artery embolization to treat the postpartum hematorrhea has a lot of advantages such as stopping bleeding quickly,being reliable curative effect,wounded lightly and few complication,and most importantly,it can reach the purpose of resering uterus