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目的探讨介入导管动脉栓塞术(Transcatheter Arterial Embolization,TAE)治疗产后出血的临床疗效和安全性。方法对6例产后出血患者行右股动脉赛丁格技术穿刺,将介入导管插至双侧髂内动脉或子宫动脉,注入优维显,同步行血管造影,明确出血部位,以明胶海绵颗粒作栓塞剂,行双侧髂内动脉栓塞或子宫动脉栓塞术。结果 5例产后出血患者栓塞后出血明显减少,仅有少量血性恶露。止血时间5～10 min,手术时间40～60 min。1例产后出血患者栓塞后仍有较多阴道出血而行二次栓塞,术后出血即刻减少,仅有少许血性分泌物。所有患者获得有效止血,术后观察无严重并发症发生,均恢复正常月经,有3例已再次妊娠。结论动脉栓塞介入治疗用于产后出血具有创伤小、止血迅速、疗效显著的特点,是急诊抢救的有效方法,值得临床推广应用。
Objective To investigate the clinical efficacy and safety of Transcatheter Arterial Embolization (TAE) in treating postpartum hemorrhage. Methods Six patients with postpartum hemorrhage underwent resection of the right femoral artery by Cydlin technique. The interventional catheter was inserted into the bilateral internal iliac arteries or uterine arteries, and the superior venous angiography was performed. Simultaneous angiography was performed to determine the bleeding site. Gelatin sponge particles Embolization agent, line bilateral internal iliac artery embolization or uterine artery embolization. Results 5 cases of postpartum hemorrhage significantly reduced bleeding after embolization, only a small amount of bloody lochia. Hemostatic time 5 ~ 10 min, operation time 40 ~ 60 min. One patient with postpartum hemorrhage still had more vaginal bleeding after thromboembolism, the hemorrhage immediately reduced, only a little bloody discharge. All patients received effective hemostasis, postoperative observation of no serious complications, were normal menstruation, 3 patients have been pregnant again. Conclusion Interventional arterial embolization for postpartum hemorrhage with trauma, rapid hemostasis, significant effect, is an effective emergency treatment, it is worthy of clinical application.