动脉栓塞术治疗盆腔大出血的应用  

Pelvis Massive Hemorrhage Treated by Artery Embolization

作　　者：李红伟[1] 翟跃杰[1] 杨思福[1] 王勇[1] 

机构地区：[1]河南省濮阳市油田总医院影像科,河南457001

出　　处：《当代医学》2009年第17期297-298,共2页Contemporary Medicine

摘　　要：目的探讨经导管动脉栓塞术(TAE)在治疗盆腔大出血中的应用价值。方法以Seldinger's技术对本组23例(膀胱癌出血3例,前列腺癌术后出血1例,子宫颈癌出血6例,子宫内膜癌出血3例,绒癌1例,产后大出血9例)不同程度盆腔出血患者行经皮双侧髂内动脉前干或子宫动脉超选择插管术,应用数字减影血管(DSA)技术明确出血部位后根据具体情况注入抗生素和/或抗癌药物,并以明胶海绵颗粒栓塞。结果全部病例均为经保守治疗无效的盆腔出血患者,经TAE治疗后一次止血成功,止血时间5～13min,平均时间(8.1±3.6)min,手术时间30～50min,平均(41.8±6.4)min;DSA发现出血均来源于单侧或双侧髂内动脉前干,表现为局灶性出血、宫腔内弥漫性出血;随访14～30天均无再出血。无严重并发症发生。结论TAE对盆腔大出血有确切的疗效,具有止血快、副作用小的特点。Objective To discuss the value of transcatheter arterial embolization for treatment of pelvic massive hemorrhage. Methods TAE was performed on 23 patients （3 bladder cancer, 1 postoperative prostate cancer, 6 cervical cancer, 3 endometrial cancer, 1 choriocarcinoma, 9 postpartum hemorrhage） with pelvic massive hemorrhage. Superselective catheterization to the bilateral uterial arteries or anterior branches of internal iliac arteries was carded out after intubation to single side femoral artery by Seldinger＇s technique. When the catheter tip was proved in right place by digital substraction angiography（DSA） techniques, antibiotic or anticarcinogen solution was injected into arteries and then gelfoam particles were used to embolize arteries. Results （1） All patients failed in haemostasis with the conservative therapy were performed TAE, and bleeding was stopped successfully at one time. The time of hemostasis was 5- 13 minutes[mean （8. 1±3.6）minutes], the operation time was 30-50 minutes[mean（41.8±6.4） minutes].（2）Bleeding as local hemorrhage or uterine diffusely bleeding was found in DSA from unilateral or bilateral anterior branches of internal iliac arteries.（3）The follow-up period was 14-30 days, no recurrent hemorrhage and no serious complications were found.Conclusion TAE has a significant effect in treating pelvic massive hemorrhage and has the characteristic of fast homeostasis and less side effect.

关 键 词：盆腔 出血 血管造影术 髂内动脉 明胶海绵 栓塞 

分 类 号：R737[医药卫生—肿瘤] R714.461[医药卫生—临床医学]