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目的评价明胶海绵颗粒栓塞治疗产后大出血的临床应用价值。方法30例产后大出血患者,均在产科经保守治疗无效,于栓塞前行双侧髂内动脉及子宫动脉造影,观察出血部位,然后用明胶海绵颗粒对出血动脉进行栓塞。结果30例患者中,18例栓塞双侧子宫动脉,5例栓塞单侧子宫动脉加对侧髂内动脉前干,7例栓塞双侧髂内动脉前干。所有患者于栓塞后造影显示出血灶消失,术后30min内出血量明显减少,3例短期内出血复发,其中2例行再次栓塞,1例行手术切除子宫。结论用明胶海绵颗粒栓塞治疗产后大出血是一种安全有效的治疗方法。
Objective To evaluate the clinical value of gelatin sponge embolization in the treatment of postpartum hemorrhage. Methods Thirty patients with postpartum hemorrhage were ineffective in obstetrics after conservative treatment. Before bilateral embolization, bilateral internal iliac artery and uterine artery angiography were performed to observe the bleeding site. Then, the hemorrhage artery was embolized with gelatin sponge particles. Results Among the 30 patients, 18 patients had bilateral uterine artery embolization, 5 patients with unilateral uterine artery embolization plus contralateral internal iliac artery, and 7 patients with bilateral internal iliac artery embolization. All patients underwent angiography after embolization showed the disappearance of hemorrhage. The amount of hemorrhage was significantly reduced within 30 minutes after operation. Three cases had recurrent hemorrhage in a short period of time, of which two cases were re-embolized and one case underwent surgical resection of the uterus. Conclusion The treatment of postpartum hemorrhage with gelatin sponge particles is a safe and effective treatment.