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中华介入放射学电子杂志 ›› 2014, Vol. 02 ›› Issue (03) : 39 -41. doi: 10.3877/cma.j.issn.2095-5782.2014.03.011

所属专题: 文献

血管介入

剖宫产术后大出血的造影表现及介入治疗
陈毅1, 谢春明1,(), 庞宁东1, 杨敏玲1, 冯对平1   
  1. 1. 030001 太原,山西医科大学第一医院介入科
  • 收稿日期:2013-06-21 出版日期:2014-08-01
  • 通信作者: 谢春明
  • 基金资助:
    山西省自然科学基金(2012011043-5)

Angiography performance and intervention therapy of hemorrhage after cesarean section

Yi Chen1, Chunming Xie1,(), Ningdong Pang1, Minling Yang1, Duiping Feng1   

  1. 1. Department of Interventional radiology, First Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2013-06-21 Published:2014-08-01
  • Corresponding author: Chunming Xie
  • About author:
    Corresponding author: Xie Chunming, Email:
引用本文:

陈毅, 谢春明, 庞宁东, 杨敏玲, 冯对平. 剖宫产术后大出血的造影表现及介入治疗[J]. 中华介入放射学电子杂志, 2014, 02(03): 39-41.

Yi Chen, Chunming Xie, Ningdong Pang, Minling Yang, Duiping Feng. Angiography performance and intervention therapy of hemorrhage after cesarean section[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2014, 02(03): 39-41.

目的

探讨剖宫产术后大出血的造影表现及子宫动脉栓塞术治疗剖宫产术后大出血的临床疗效。

方法

收集26例剖宫产术后大出血患者资料,出血量500~2500 ml。局麻下经股动脉穿刺,将4F Cobra导管选择至双侧子宫动脉,用自制的明胶海绵颗粒将子宫动脉分支栓塞,最后用明胶海绵块(条)栓塞子宫动脉主干。栓塞满意后,将导管退出子宫动脉至髂内动脉造影,证实栓塞完全。

结果

患者均一次性插管成功,其中25例患者成功止血,栓塞后48 h内出血停止,血红蛋白(HGB)术前与术后分别为(65.3±7.4)g/L和(83.5±5.6)g/L,差别有统计学意义(P<0.01),无严重并发症发生。患者子宫动脉栓塞术后至康复出院的时间为1~8天,平均(3.9±2.2)天。

结论

子宫动脉栓塞术治疗剖宫产术后出血,创伤小,成功率高,并发症少,住院时间短,大大降低了医疗风险,值得临床推广。

Objective

To evaluate angiography performance of hemorrhage after cesarean section and clinical efficacy of uterine artery embolization for bleeding after cesarean section.

Methods

Data of 26 patients with cesarean section bleeding, their bleeding was from 500 ml to 2500 ml. 4F Cobra catheter were selected to the uterine artery through the femoral artery puncture under local anesthesia. Gelatin sponge particles were used to embolize uterine artery branches And Gelatin sponge bricks/sticks were used to embolize uterine artery. After embolization, the catheter was selected to the internal iliac for angiography to confirmed embolizing successfully.

Results

The patients were one-time intubation success. Twenty-five patients stop bleeding after embolization in 48 h. The preoperative and postoperative hemoglobin (HGB) were (65.3±7.4)g/L and (83.5±5.6)g/L, there was no statistical different between the two (P<0.01) and no serious complications. Patients with uterine artery embolization leave hospital 1—8 days later, average of 3.9±2.2 days.

Conclusion

Uterine artery embolization for hemorrhage after cesarean section is trauma small, high success rate, fewer complications, shorter hospital stay, and greatly reduce the medical risk. It is worthy of wide popularize.

表1 7例产后晚期出血患者的资料
1
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Driessen M,Bouvier-Colle MH,Dupont C, et al. Postpartum hemorrhage resulting from uterine atony after vaginal delivery: factors associated with severity[J]. Obstet Gynecol, 2011,117(1):21-31.
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吴连方,刘妍,阮焱,等.卡前列素防治高危产妇剖宫产术中及术后出血的临床研究[J].中华妇产科杂志,2007,42(9):577-581.
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Kovo M,Behar DJ,Friedman V, et al. Pelvic arterial pseudoaneurysm—a rare complication of Cesarean section: diagnosis and novel treatment[J]. Ultrasound Obstet Gynecol, 2007, 30(5):783-785.
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Descargues G,Douvrin F,Gravier A, et al. False aneurysm of the uterine pedicle: an uncommon cause of post-partum haemorrhage after caesarean section treated with selective arterial embolization[J]. Eur J Obstet Gynecol Reprod Biol 2001,97(1):26-29.
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Higon MA,Domingo S,Bauset C,Martinez J, et al. Hemorrhage after myomectomy resulting from pseudoaneurysm of the uterine artery[J]. Fertil Steril,2007,87(2):417-418.
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Zimon AE,Hwang JK,Principe DL, et al. Pseudoaneurysm of the uterine artery[J]. Obstet Gynecol, 1999,94 (5 Pt 2):827-830.
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胡科丽,朱明娟.剖宫产大出血74例临床分析[J].中国妇幼保健,2006,21(19):2656-2657.
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胡鹏,李玉伟,李云辉,等.剖宫产后出血原因分析及介入治疗的价值[J].介入放射学志,2011,20(8):613-616.
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