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盆腔大出血(PMH)手术止血困难,常危及患者生命.经导管栓塞治疗(TCE)是抢救患者生命的有效措施,能立即和持久止血。我院自1987年以来,采用TCE 治疗盆腔大出血18例,其中产伤,产后出血8例,妇科肿瘸出血7例(绒癌2例、恶葡2例,子宫肌瘤术后出血2例、卵巢癌出血1例),直肠癌侵及膀胱和阴道大出血各1例,臀部刀伤后血肿1例。全部病例中除1例产后大出血经多次栓塞才止血外,其余病例均1次栓塞后立即止血,并随访观察(观察时间2～102天)均无再出血.所用栓塞剂为明胶海绵,部分病例采用明胶海绵与闭塞弹簧圈合并应用.全部病例除栓塞后一过性臀部缺血性疼痛外,无1例有并发症发生.本文对栓塞方法、栓塞剂的选择及并发症进行了探讨.
Pelvic bleeding (PMH) surgery to stop bleeding difficult, often endanger the lives of patients. Transcatheter embolization (TCE) is an effective measure to save the lives of patients, can immediately and long-lasting hemostasis. In our hospital since 1987, 18 cases of pelvic hemorrhage have been treated with TCE, including 8 cases of postpartum hemorrhage, 7 cases of postpartum hemorrhage, 7 cases of gynecological swollen hemorrhage (2 cases of choriocarcinoma, 2 cases of dysentery, 2 cases of postoperative bleeding of uterine fibroids, One case of ovarian cancer hemorrhage, one case of rectal cancer invading bladder and vaginal bleeding, and one case of hematoma after buttocks injury. In all cases, except one case of postpartum hemorrhage that stopped bleeding after multiple embolizations, the other cases immediately stopped bleeding after one embolization. No follow-up was observed (observation time was 2 to 102 days). The embolization agent used was a gelatin sponge. The cases were treated with gelatin sponge and occluded coils. In all cases except transient ischemic hip pain after embolization, none of the cases had complications. The embolization method, choice of embolic agent and complications were discussed in this paper.