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目的:探讨经导管动脉栓塞术(TAE)治疗和预防产科大出血的疗效及安全性。方法:产科大出血或有大出血风险病例17例。选择性插管至双侧子宫动脉或髂内动脉,行DSA明确子宫血管情况,以直径1~3 mm明胶海绵颗粒及明胶海绵条或聚乙烯醇(PVA)栓塞,部分病例经子宫动脉灌注甲氨喋呤(MTX)。结果:插管成功率100%,14例大出血病例栓塞后活动性出血停止,手术成功,1~5 d后阴道内完全无流血。3例预防性栓塞患者,栓塞后行引产术,1例发生大出血,2例未发生大出血。结论:TAE是一种迅速、简单、安全有效可保留子宫的好方法,对有大出血风险病例预防应用可降低大出血或死亡的风险。
Objective: To investigate the efficacy and safety of transcatheter arterial embolization (TAE) in the treatment and prevention of obstetric hemorrhage. Methods: Obstetrical bleeding or bleeding in 17 cases. Select the catheter to the bilateral uterine artery or internal iliac artery, DSA clear uterine vascular conditions, to 1 ~ 3 mm in diameter gelatin sponge particles and gelatin sponge or polyvinyl alcohol (PVA) embolization, in some cases by uterine artery perfusion Aminopterin (MTX). Results: The successful rate of intubation was 100%. In 14 cases of massive hemorrhage, the active bleeding was stopped after the embolization. The operation was successful. There was no bleeding after 1 to 5 days in the vagina. Three patients with prophylactic embolism were treated with induction of labor after embolization, one with massive hemorrhage and two with no major bleeding. CONCLUSION: TAE is a rapid, simple, safe and effective way to preserve the uterus. The prevention and treatment of cases with high bleeding risk may reduce the risk of major bleeding or death.