再次子宫动脉栓塞术治疗获得性子宫动静脉瘘反复阴道流血临床疗效研究(附7例报告)  

Repeated uterine artery embolization in the treatment of acquired uterine arteriovenous fistula resulted in repeated vaginal bleeding

作　　者：于昕[1] 朱兰[1] 史宏晖[1] 樊庆泊[1] 郎景和[1] 

机构地区：[1]中国医学科学院北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2016年第5期450-452,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨再次子宫动脉栓塞术治疗获得性子宫动静脉瘘反复阴道流血的临床价值。方法回顾性分析北京协和医院1997年6月至2015年6月收治的7例获得性子宫动静脉瘘于子宫动脉栓塞术后反复阴道流血患者的临床诊断和再次子宫动脉栓塞术治疗的效果。结果7例患者经彩色多普勒和血管造影明确诊断子宫动静脉瘘，均再次行双侧子宫动脉栓塞术治疗。5例患者再次栓塞治疗成功（成功率为5／7），另2例分别于再次栓塞术后1周、2年因经期阴道大出血行全子宫切除术、所有患者于术后3个月内恢复月经，随访1～17年，均未再出现阴道大出血，其中1例于再次栓塞术后10个月自然妊娠。术后1例出现高热、1例伴有轻微腹痛，余无并发症发生。结论年轻并要求保留生育功能的获得性子宫动静脉瘘反复阴道流血患者，再次子宫动脉栓塞术仍可做为首选治疗方法。Objective To explore the clinical value of repeated uterine artery embolization in the treatment of acquired uterine arteriovenous fistula resulted in repeated vaginal bleeding. Methods Retrospectively analyze the clinical diagno- sis of 7 patients in Peking Union Medical College Hospital from June 1997 to June 2015 who were treated in our hospital characterized as repeated vaginal bleeding after uterine artery embolization because of uterine arteriovenous fistula and the effectiveness of repeated uterine artery embolization.Results The 7 patients all definitely diagnosed with uterine ar- teriovenous fistula by Color Doppler and angiography and all accepted bilateral repeated uterine artery embolization . Five of them were cured by bilateral repeated uterine artery embolization （5/7） and returned to menstruation in 3 months. During the following period of 1 ～ 17 years, none of the 5 patients complained of massive vaginal bleeding again and one of them had a natural pregnancy in 10 months after the repeated uterine artery embolization.The other 2 patients accept- ed hysterectomy 1 week and 10 months respectively after the repeated uterine artery embolization because of massive vag- inal bleeding. Conclusion Repeated uterine artery embolization still can be used as the first choice for the young pa- tients characterized as repeated vaginal bleeding because of uterine arteriovenous fistula who desire fertility.

关 键 词：子宫动静脉瘘 反复阴道流血 子宫动脉栓塞术 

分 类 号：R711.74[医药卫生—妇产科学]