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目的 :分析不同原因导致的产后大出血各自的数字减影血管造影 (DSA)表现 ,探讨介入治疗的价值。方法 :本文收集 17例产后大出血病人 ,其中经阴道分娩后 7例 ,剖腹产后 8例 ,人工流产后 2例。均行DSA检查 ,明确出血部位及出血原因后栓塞子宫动脉或 (和 )髂内动脉 ,栓塞剂为明胶海绵和 (或 )金属弹簧圈。结果 :DSA表现为宫腔内弥漫性出血 8例 ,宫腔内局灶性出血 2例 ,子宫动脉分支受损出血 4例 ,出血部位不明 3例。栓塞靶动脉后均成功止血。结论 :不同原因引起的产后大出血DSA表现各有特点 ,介入治疗疗效佳 ,并发症少 ,可取代传统的子宫切除术
Objective: To analyze the digital subtraction angiography (DSA) manifestations of postpartum hemorrhage caused by different causes and to explore the value of interventional therapy. Methods: This article collected 17 cases of postpartum hemorrhage patients, including 7 after vaginal delivery, 8 after caesarean section, 2 after induced abortion. All patients underwent DSA examination. The uterine artery or (and) internal iliac artery was embolized after the site of hemorrhage and the cause of bleeding were identified. The embolic agent was gelatin sponge and / or metal coil. Results: DSA showed intrauterine diffuse hemorrhage in 8 cases, intrauterine focal hemorrhage in 2 cases, uterine artery branch bleeding in 4 cases and unknown bleeding site in 3 cases. Embolization of the target artery after successful hemostasis. Conclusion: DSA manifestations of postpartum hemorrhage caused by different causes have their own characteristics, interventional therapy has good curative effect and few complications, which can replace traditional hysterectomy