双侧子宫动脉化疗栓塞术治疗剖宫产后瘢痕妊娠大出血的临床应用  

Clinical application of bilateral uterine arterial chemoembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy

作　　者：万军[1] 顾伟瑾[1] 王海云[1] 叶磊[1] 王玮[1] 张磊[1] 纪莉华[1] 

机构地区：[1]上海市静安区中心医院介入科,200040

出　　处：《介入放射学杂志》2009年第7期499-502,共4页Journal of Interventional Radiology

摘　　要：目的探讨剖宫产后子宫瘢痕妊娠(CSP)大出血急诊双侧子宫动脉化疗栓塞术的应用价值。方法16例CSP大出血患者平均出血量(2200±1400)ml,采用Seldinger法先行猪尾导管腹主动脉造影,明确是否为双侧子宫动脉出血后,选择或超选择性插管,造影证实后分别经导管于双侧子宫动脉内灌注5-Fu或MTX和明胶海绵条栓塞。结果16例CSP大出血患者全部栓塞成功,随访3～6个月无再次大出血。结论急诊双侧子宫动脉化疗栓塞术治疗CSP大出血既安全、有效,又无严重并发症,值得临床推广使用。Objective To investigate the clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to uterine scar pregnancy after cesarean section. Methods Sixteen patients with massive hemorrhage due to cesarean scar pregnancy were enrolled in the study, the mean blood loss was （2 200 ± 1 400） ml. With Seldinger technique, abdominal angiography by using a pig-tail catheter was carried out. When bilateral uterine arterial bleeding was confirmed, selective or super-selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion of 5-Fu or methotrexate （MTX） together with gelatin sponge via the catheters was conducted. The clinical results were observed. Results The technical success was achieved in all 16 patients. No recurrent bleeding occurred during a follow-up of 3-6 months. Conclusion The emergency bilateral uterine arterial chemoembolization is a safe and effective treatment for massive hemorrhage due to cesarean scar pregnancy with no serious complications, therefore, this technique is worth being used in clinical practice.

关 键 词：动脉栓塞 明胶海绵 剖宫产子宫瘢痕 妊娠 妇科大出血 

分 类 号：R719.8[医药卫生—妇产科学] R714.22[医药卫生—临床医学]