卵巢动脉栓塞在子宫出血性疾病介入治疗中的意义  

The significance of ovarian artery embolization in interventional therapy of uterine hemorrhagic diseases

作　　者：冯志鹏 张建好[1] 韩新巍[1] 赵艳萍[1] 侯宇虹[1] 郭瑞霞[1] 李留霞[1] 赵先兰[2] 杨玲竹[2] 纪妹[3] FENG Zhipeng;ZHANG Jianhao;HAN Xinwei;ZHAO Yanping;HOU Yuhong;GUO Ruixia;LI Liuxia(Department of Interventional Radiology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院介入科,450052 [2]郑州大学第一附属医院产科,450052 [3]郑州大学第一附属医院妇科,450052

出　　处：《介入放射学杂志》2019年第8期778-781,共4页Journal of Interventional Radiology

摘　　要：目的评价卵巢动脉栓塞术(OAE)应用于子宫出血介入治疗的有效性和安全性,探讨其临床意义。方法对34例卵巢动脉(OA)参与供血的子宫出血性疾病患者行OAE,其中产后出血17例,子宫恶性肿瘤7例,瘢痕妊娠5例,子宫肌瘤5例。25例子宫动脉栓塞后造影发现OA供血,予补充OAE;9例介入治疗后未见明显OA供血,术后72h内再发出血,二次介入治疗中OA明显供血,遂行OAE。结果OAE术后患者出血随即停止,贫血症状明显改善。7例胎盘植入患者术后1~2周胎盘排出体外,2例胎盘残留宫内和5例瘢痕妊娠患者清宫术中出血量<200mL,恶性肿瘤患者后续治疗中未再大出血,子宫肌瘤患者月经量恢复正常,无肌瘤复发。8例术后出现卵巢衰竭症状,但均为可逆性,2~4个月症状逐渐改善。结论子宫出血性疾病介入治疗中若OA参与供血,予以OAE安全有效,但应把握应用指征及流程。Objective To evaluate the efficacy and safety of ovarian artery embolization (OAE) in interventional therapy of uterine hemorrhage,and to discuss its clinical significance.Methods OAE was employed in 34 patients of uterine hemorrhagic disease with ovarian artery(OA) involved in blood supply.The diseases included postpartum hemorrhage(n=17),uterine malignant tumor (n=7),scar pregnancy (n=5) and uterine fibroids (n=5).Post-embolization angiography in 25 patients showed that OA participated in blood supply,and supplementary OAE was carried out.In 9 patients,no obvious OA blood supply was observed after interventional treatment,and recurrent hemorrhage occurred within 72 hours after OAE.Angiography performed in the second interventional therapy revealed that obvious blood supply from OA was detected,and OAE had to be carried out again.Results The bleeding stopped immediately after OAE and the symptoms of anemia were improved obviously.In 7 patients with placenta implantation,the placenta was discharged from the body within 1-2 weeks after OAE.Placental residue in uterus was observed in 2 patients,and in 5 patients with scar pregnancy the volume of blood loss during uterine curettage was less than 200 ml.In patients with malignancy,no more massive bleeding occurred in subsequent treatment.Menstrual volume returned to normal in patients with uterine fibroids and no recurrence was observed.After the treatment,8 patients developed symptoms of ovarian failure,but all the symptoms were reversible and were improved within 2-4 months.Conclusion In treating uterine hemorrhagic diseases,OAE is safe and effective when OA is involved in the blood supply of the lesion.However,the indications and procedures of OAE should be strictly observed.

关 键 词：卵巢动脉栓塞术 子宫动脉栓塞术 子宫出血 意义 

分 类 号：R719.8[医药卫生—妇产科学]