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目的探讨在产后出血中应用子宫动脉栓塞的治疗效果。方法对2003年至2010年在陕西省汉中市中心医院就诊的16例产后出血患者(剖宫产9例、顺产5例、中期引产2例)行子宫动脉栓塞治疗止血(使用明胶海绵颗粒及弹簧圈)。结果 15例患者术后24 h总出血量<80 ml,5例72 h出血停止,1例栓塞后6 h因持续阴道流血,并凝血功能异常、弥散性血管内凝血行子宫切除术。结论选择性子宫动脉栓塞是治疗产后出血的有效方法,避免了开腹及再次手术损伤,当一线治疗失败时优于外科手术及子宫切除,能够保留患者子宫及生育功能。
Objective To investigate the therapeutic effect of uterine artery embolization in postpartum hemorrhage. Methods 16 cases of postpartum hemorrhage (9 cases of cesarean section, 5 cases of cesarean section and 2 cases of mid-term induction of labor) were treated by uterine arterial embolization in Hanzhong Central Hospital of Shaanxi Province from 2003 to 2010. The hemostasis was treated with gelatin sponge particles and spring ring). Results The total amount of hemorrhage was less than 80 ml in 24 cases, the bleeding stopped in 72 cases in 5 cases, the vaginal bleeding in 6 cases at 6 hours after embolization and coagulation abnormalities were performed in 15 patients. Hysterectomy was performed in disseminated intravascular coagulation. Conclusions Selective uterine artery embolization is an effective method to treat postpartum hemorrhage. It avoids open surgery and reoperational injuries. It is superior to surgery and hysterectomy when the first - line treatment fails, which can keep the uterus and reproductive function.