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目的探讨髂外动脉有关的产后出血的影像特征及其所相关的产后出血介入治疗措施。方法通过回顾分析山西省人民医院介入科治疗的1例与髂外动脉有关的产后出血患者的临床及影像学表现,检索国内外文献,归纳整理,总结其共性,探讨其影像特征及其所相关的产后出血介入治疗措施。结果髂外动脉有关的产后出血共有报道4例,均为国内报道。其中,右侧髂外动脉2例,双侧髂外动脉2例,栓塞3支旋髂深动脉参与子宫血供的异常分支后出血停止。结论对于产后出血患者子宫动脉栓塞(UAE)后,应行腹主动脉造影,注意对髂外动脉的观察;UAE后复发出血者,应该考虑到髂外动脉异常分支参与子宫血供的可能;在栓塞髂外动脉的异常分支时,应尽量将导管送至靶血管远端,再在DSA监视下缓慢注入栓塞剂并严密观察反流。一般情况下栓塞髂外动脉异常分支不会发生盆腔及远端肢体缺血症状。
Objective To investigate the characteristics of post-partum hemorrhage related to external iliac artery and its related interventional measures for postpartum hemorrhage. Methods The clinical and imaging findings of one case of postpartum hemorrhage associated with external iliac artery treated by interventional department of Shanxi Provincial People’s Hospital were retrospectively analyzed. The domestic and foreign literatures were retrieved and summarized. The common features were summarized and their image characteristics and their correlation were discussed Interventional treatment of postpartum hemorrhage. Results External iliac artery related postpartum hemorrhage were reported in 4 cases, all reported in the country. Among them, the right external iliac artery in 2 cases, bilateral external iliac artery in 2 cases, embolization of three deep iliac artery involved in abnormal blood supply to the uterus bleeding stopped. Conclusions For uterine arterial embolism (UAE) in patients with postpartum hemorrhage, abdominal arteriography should be performed and attention should be paid to the observation of the external iliac artery. Patients who have hemorrhage after UAE should consider the possible involvement of the abnormal branches of the external iliac artery in uterine blood supply. When embolizing the abnormal branch of the external iliac artery, the catheter should be delivered to the distal end of the target vessel, and then slowly injected with embolization agent under the surveillance of DSA and closely monitored for reflux. Under normal circumstances embolization of the external iliac artery anomalies do not occur pelvic and distal limb ischemia symptoms.