不同原因产后大出血的盆腔动脉造影分析

目的　分析不同原因产后大出血的盆腔动脉造影征象。方法　收集 10例产后大出血行介入栓塞治疗患者的盆腔动脉造影结果进行分析,并与临床资料对比。结果　5例宫缩乏力性出血的造影征象为双侧子宫动脉上行支明显造影剂外溢,呈不规则结节状,或片状,或弥漫性外溢; 2例剖宫产术后子宫切口愈合不良的造影可见原子宫切口部位片状或条索状或团状外溢的造影剂;2例软产道裂伤者,造影显示子宫动脉上行支显现清晰,一侧或两侧的子宫动脉下行支有明显片状造影剂外溢; 1例子宫血管畸形造影显示左侧子宫动脉上行支的一个分支明显增粗,造影剂直通宫腔。结论　不同原因产后出血的盆腔动脉造影有其特殊的影像学征象;盆腔动脉造影结合临床资料和其他辅助检查,可以为产后出血的原因分析提供更为准确、更为直观的临床诊断依据。

Analysis of Pelvic Arteriography in Postpartum Hemorrhage

Objective To analyze the features of pelvic arteriography in postpartum hemorrhage.Methods The pelvic arteriographic results of postdelivery hemorrhage caused by differeut cause in 10 patients whom were treated with artery embolization were analysed and compared with the clinical data.Results The arteriographic features included irrgeular nodose or diffuse outflow of contrast medium in bilateral upper branches of uterine artery in 5 cases with atonic uterus streaky or cloudy contrast medium in the site of uterine incision in 2 cases after caesarean.In two cases with incomplete laceration in the lower portion of soft puerperant tract,there was distinct outflow of contrast medium in one side or bilateral down branches of uterine artery but its bilateral upper branches was displayed clearly.On angiography in one case with uterine vascular malformation displayed one of upper uterine branch was enlarged and the constrast medium flowed into utrine cavity directly.Conclusion Pelvic arteriography in postpartum hemorrhage with different causes has its special findings.Arteriography in combination with the clinical data can afford more direct and accurate informations for analysing the causes of postpartum hemorrhage causes.