【摘要】 目的:探讨难治性妇产科大出血介入栓塞治疗的临床价值和意义。方法:47例难治性妇产科大出血患者,包括产后宫缩乏力、引产后大出血、宫颈妊娠、子宫切除术后残端出血、宫颈鳞癌等。处于失血性休克状态35例,出现弥漫性血管内凝血(DIC)9例。采用Seldinger技术行右股动脉穿刺插管双侧髂内动脉造影后,行双侧髂内动脉栓塞,栓塞剂为明胶海绵。结果:44例经一次栓塞后成功止血,手术时间30～65min,平均45 min。1例子宫切除术后大出血经三次栓塞后成功止血,1例经一次栓塞后仍有活动性出血行子宫切除术,1例经两次栓塞后仍有活动性出血行子宫切除术。结论:介入栓塞治疗妇产科大出血是一种有效、迅速、安全的止血方法。更多还原

【Abstract】 Objective:To evaluate the clinical value of urgent interventional embolism to treat intractable massive hemorrhage in obstetrics and gynecology.Methods:Forty seven patients with intractable bleeding in obstetrics and gynecology,including uterine atony induced postpartum hemorrhage,odinopoeia bleeding,cervical pregnancy,hysterectomy stump bleeding,cervical cancer and so on.35 patients with(bleeding) shock and 9 patients with DIC were all saved.All cases underwent right femoral artery puncture by Seldinger’s technique.Super selective catheterization to the bilateral internal iliac arteries angiography was performed.Then bilateral internal iliac arteries were embolized.The emboli material was Gelfoam particles.Results:44 patients were rescued successfully after embolizing internal iliac arteries,and bleeding was stopped successfully at one time.The operation time was 30～65 minutes(mean 45 minutes).1 patient with hysterectomy stump bleeding was controlled by third time embolization,1 patient by one time embolization but other by two time embolization still bleeding received a hysterectomy.Conclusion:Emergent embolization is an effective,quick,and safe therapeutic measure for treatment of massive hemorrhage in obstetrics and gynecology.更多还原