切换至 "中华医学电子期刊资源库"

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/OL]. 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/OL]. 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
林建华,林其德,刘兴会,等.益母草注射液预防剖宫产产后出血的多中心临床研究[J].中华妇产科杂志,2009,44(3):175-178.
2
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.
3
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.
4
秦秀菊,双艳平.剖宫产产后出血132例危险因素分析[J].中国妇幼保健.2008,23(26): 3676-3678.
5
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.
6
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.
7
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.
8
Zimon AE,Hwang JK,Principe DL, et al. Pseudoaneurysm of the uterine artery[J]. Obstet Gynecol, 1999,94 (5 Pt 2):827-830.
9
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.
10
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.
11
陈毅,谢春明,杨敏玲,等.子宫动脉栓塞术在剖宫产术后子宫瘢痕妊娠治疗中的应用[J].介入放射学杂志, 2012,21(5):410-413.
[1] 马桥桥, 张传开, 郭开今, 蒋涛, 王子豪, 刘勇, 郝亮. 可降解止血粉减少初次全膝关节置换术失血量的研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 585-589.
[2] 张秋阳, 余韶芸, 潘向滢, 金家佳, 夏桦, 赵雪红. 成年体外膜肺氧合患者出血影响因素的Meta 分析[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 392-398.
[3] 张舒沁, 陈练. 产后宫腔内妊娠物残留的诊断和临床处理[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 493-497.
[4] 周正阳, 陈凯, 仇多良, 邵乐宁, 吴浩荣, 钟丰云. 腹腔镜腹股沟疝修补术后出血原因分析及处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 660-664.
[5] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[6] 公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[7] 李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[8] 王永楠, 汤畅通, 殷杰, 谭溢涛. 微创钻孔引流术与神经内镜血肿清除术治疗临界量基底节脑出血的效果对比分析[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 286-292.
[9] 张志超, 李陈, 韩惠, 周夏, 洪家康. 经额平行白质纤维束立体定向血肿穿刺引流术与神经内镜下血肿清除术治疗基底节脑出血的临床对比分析[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 299-303.
[10] 李晓东, 王汉宇, 马龙, 刘亮, 魏云, 李昂. 小脑后下动脉瘤的显微手术治疗[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 318-320.
[11] 吴广迎, 张延娟, 秦鹏, 卢艳丽. 经颈静脉肝内门体静脉分流术预防上消化道出血的临床研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 545-548.
[12] 梁艳娉, 陈燕柔, 梁运啸, 白飞虎, 吴斌, 王省. 华南地区门静脉高压食管胃静脉曲张出血内镜治疗现状调研分析[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 390-395.
[13] 董晟, 郎胜坤, 葛新, 孙少君, 薛明宇. 反向休克指数乘以格拉斯哥昏迷评分对老年严重创伤患者发生急性创伤性凝血功能障碍的预测价值[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 541-547.
[14] 穆巴拉克·伊力哈, 徐霁华, 鲁明. 急性轻型卒中微量脑出血误诊病例的临床特点及影像学表现分析[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 441-445.
[15] 赵伟伟, 赵玉华, 刘小璇. 西藏地区亚甲基四氢叶酸还原酶C677T多态性及其与脑微出血的相关性[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 473-478.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?