急诊介入栓塞治疗产后大出血的临床观察.doc

急诊介入栓塞治疗产后大出血的临床观察 作者：李建文,张剑,舒建军,杨学俊,童彦芳 单位：宁夏石嘴山市第一人民医院，宁夏 石嘴山 【摘要】 目的 探讨急性产后大出血行超选择性子宫动脉栓塞的治疗效果及临床应用价值。方法 对16例急性产后出血病例，采用改良Seldinger技术经皮股动脉穿刺行子宫动脉插管并造影,造影后采用明胶海绵颗粒栓塞，术后随访观察出血、血压、子宫复旧等情况。结果 16例产后出血患者双侧子宫动脉全部插管，15例栓塞成功，栓塞术后30 min内阴道流血量显著减少,栓塞术后病人仅表现轻微的疼痛和不同程度的发热。1例因止血不完全而行子宫次全切除术。15例随访4-11个月患者均有规律的月经来潮，无严重并发症发生。结论 超选择性子宫动脉栓塞具有创伤小、止血迅速、彻底、可保留子宫等优点，是急性难治性产后出血最安全、有效的止血手段,并保留子宫的完整和正常生理功能。 【关键词】 子宫动脉；产后出血；放射学；介入治疗；栓塞 The clinical effect of emergency arterial embolism treatment in postpartum hematorrheaLI Jian-wen，ZHANG Jian，SHU Jian-jun，et al.　(The First Peoples Hospital of Shizuishan,Ningxia 753200,China)　　［Abstract］ Objective Discuss the acute massive hemorrhage in the postpartum line surpassing the selectivity womb arterial embolisms curing effect and clinical practice value。Methods 16 impatient postpartum hemorrhage of example case，Adopt Seldingers technologies to do the womb arterial plunging tube and the radiography after skin share arteriopuncture, The radiography queen adopt the gelatin foam rubber or plastic pellet embolism, Condition such as bleeding , blood pressure , womb backswing the postoperative follow-up is observed. Results 16 example postpartum hemorrhages patients incline all womb arterial plunging tubes pair, 15 example embolisms are successful, Embolism the vagina bleeds within 30 min measuring the notable decrease, the embolism skill queen patient shows slight pain and fever heat to varying degrees only, grave complication appear on example without 1. 1 example satisfies a resection time because of the incomplete but capable womb stanching bleeding. 15 example follow-ups 4 ～ 11 months patients menses having law without exception rising, Happen without grave complication. Conclusion Surpass the selectivity womb arterial embolism having wound merit such as small , stanching bleeding to may reserve a womb prompt , thorough, Be an impatient function difficult to bring safe , effective hemostasis of nature postpartum hemorrhage means under control, an