【摘要】 目的 探讨急诊介入栓塞治疗妇产科继发性出血的临床价值。方法 20例严重妇产科继发出血患者,选择性插管双侧髂内动脉、子宫动脉进行急诊介入栓塞治疗,栓塞物质为明胶海绵颗粒、真丝线段/颗粒或弹簧圈。对于9例恶性肿瘤,同时经微导管进行局部灌注化疗。所有病例术后追踪观察3～36个月。结果 介入栓塞治疗对继发出血的控制情况:临床治愈16例,占80%;有效3例,占15%;1例无效,占5%。19例患者保留了子宫,1例介入治疗无效患者后进行子宫切除术。经过3～36个月随访,1 1例育龄期女性均恢复正常月经周期。无严重与栓塞相关并发症发生。结论 急诊介入治疗是改善严重妇产科出血性疾病预后的首选方法。更多还原

【Abstract】 Objective To approach the value of emergency interventional therapy for secondary hemorrhage in obstetrics and gynecology.Methods 20 cases of serious secondary hemorrhage of obstetrics and gynecology were successfully managed with selective bilateral internal iliac artery or uterine artery embolization.The embolic materials were gelatin sponge particles,silk segments and/or particles,or metallic coils.At the same time,9 cases of malignant tumour underwent local infusing chemotherapy with co-axial catheter.All cases were followed-up for 3 to 36 months after interventional therapy.Results The bleeding was completely stopped in 16(80%) cases,partially stopped in 3(15%) and one case failed after interventional therapy.The uterus were preserved in 19 cases.Hysterectomy had been performed in 1 case after embolization.In following-up period,11 patients had normal menstruate and no serious complications related to embolization were found.Conclusion The emergency interventional therapy was proved to be the first choice to improve the prognosis for intractable secondary hemorrhage in obstetrics and gynecology.更多还原