明胶海绵颗粒栓塞治疗产后大出血的临床应用

目的评价明胶海绵颗粒栓塞治疗产后大出血的临床应用价值。方法30例产后大出血患者,均在产科经保守治疗无效,于栓塞前行双侧髂内动脉及子宫动脉造影,观察出血部位,然后用明胶海绵颗粒对出血动脉进行栓塞。结果30例患者中,18例栓塞双侧子宫动脉,5例栓塞单侧子宫动脉加对侧髂内动脉前干,7例栓塞双侧髂内动脉前干。所有患者于栓塞后造影显示出血灶消失,术后30min内出血量明显减少,3例短期内出血复发,其中2例行再次栓塞,1例行手术切除子宫。结论用明胶海绵颗粒栓塞治疗产后大出血是一种安全有效的治疗方法。

Clinical application and study of interventional embolization in the treatment of postpartum hemorrhage

Objective To evaluate the clinical value of embolization of pelvic arteries for intractable postpartum hemorrhage.Methods 30 patients with intractable postpartum hemorrhage were treated by interventional embolization of pelvic arteries.The angiography of double iliac arteries was employed before embolization in routine to observe the locations of hemorrhage.The super-selective embolization of blooding arteries was employed.The anterior stems of iliac arteries were embolized only when the catheterization of uterine arteries was too difficult.The embolic agent was gelfoam particles.Results The double uterine arteries were embolized in 18 cases,single uterine arteries and contra-lateral interior stems of iliac arteries in 5 cases and double interior stems of iliac arteries in 7 cases.The post-embolization angiography showed the hemorrhage disappeared.The hemorrhage was recurred in two cases after embolization.Conclusion Interventional embolization with gelfoam particles for intractable postpartum hemorrhage is safe and effective.