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目的探讨血管性介入治疗用于妇产科大出血的临床价值。方法对保定市第二中心医院2004年9月-2012年5月35例经保守治疗无效的妇产科大出血患者,应用Seldinger’s技术行右侧股动脉穿刺插管,在数字减影血管造影(DSA)的监视下,明确出血部位,以携带有抗生素的明胶海绵颗粒(1～3 mm)对双侧子宫动脉或双侧髂内动脉进行栓塞止血。结果 35例患者均一次性止血成功,且保留了子宫。平均手术时间(49.12±6.9)min。栓塞术后病人仅表现出不同程度的疼痛及发热症状,经对症治疗后缓解,并无严重并发症发生。除一例宫颈癌患者术前已绝经外,其余患者术后月经均恢复正常。结论血管性介入在妇产科大出血的治疗中具有微创、快速、准确、疗效好、最重要的是保留了患者子宫及生育能力等优点,值得在临床推广。
Objective To investigate the clinical value of vascular interventional therapy in obstetrics and gynecology major hemorrhage. Methods A total of 35 patients with obstetric and gynecologic bleeding after conservative treatment in the Second Central Hospital of Baoding from September 2004 to May 2012 were treated with Seldinger’s technique on the right femoral artery. ), The site of hemorrhage was clearly identified and embolization of the bilateral uterine artery or bilateral internal iliac arteries was stopped with gelatin sponge particles (1 to 3 mm) containing antibiotics. Results All 35 patients had a one-time hemostasis, and retained the uterus. The average operation time (49.12 ± 6.9) min. Patients after embolization showed only varying degrees of pain and fever symptoms, symptomatic treatment after remission, no serious complications. Except for a case of cervical cancer preoperative menopause, the rest of the patients had normal menstruation. Conclusion Vascular intervention in the treatment of gynecologic hemorrhage with minimally invasive, rapid, accurate, good effect, the most important thing is to retain the advantages of the patient’s uterus and fertility, it is worth in the clinical promotion.