血管介入治疗急诊难治性产后出血6例-东南大学学报医学版

血管介入治疗急诊难治性产后出血6例

单位：1.东南大学附属中大医院,妇产科,江苏,南京,210009； 2.东南大学附属中大医院,放射科,江苏,南京,210009

分类号：R459.9, R714.461

出版年·卷·期（页码）：2005·24·第四期（250-252）

摘要：

目的:探讨难治性产后出血急诊血管介入止血的临床价值.方法:对6例难治性产后出血,出血量1 700ml～2 800ml,出血原因为软产道损伤、子宫收缩乏力、胎盘因素、凝血机能障碍,经临床药物治疗无效,难以控制出血者行急诊血管介入止血,采用超选择髂内动脉插管,造影明确诊断后用经高温、高压消毒的明胶海绵颗粒栓塞靶血管.结果:插管成功率100%,栓塞后立即止血5例(5/6),无效1例(1/6).结论:急诊介入栓塞止血安全、迅速、微创、有效,是治疗产后大出血的理想方法,不仅能挽救生命,而且能避免外科手术而保留子宫.

Objective To investigate the clinic value of urgent selective arterial embolization on massive postpartum hemorrhage. Method Six cases of severe postpartunm hemorrhage,due to birth canal trauma,placenta accretio,uterine atony,dysfunction of blood coagultion,with a loss of blood about 1 700 ml to 2 800 ml which could not be controlled with medication,underwent urgent hemostatic embolization. All of the cases were chosen to be catheterized, and gelfoam was injected into arteries for embolization after angiography proved. Result Catheterization successed in all cases. Immediate block of hemorrhage took place in 5 cases,but failed in one case. Conclusion Urgent arterial embolization is an ideal method for treating life-threatening postpartum hemorrhage.

参考文献：

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