医源性阴道大出血介入治疗的临床疗效分析  

Clinical efficacy analysis of interventional treatment of iatrogenic massive vaginal bleeding

作　　者：秦胜东 李超迪 侯宇虹[1] 赵艳萍[1] 闫肃 郭瑞霞[1] 韩新巍[1] 张建好[1] QIN Shengdong;LI Chaodi;HOU Yuhong;ZHAO Yanping;YAN Su;GUO Ruixia;HAN Xinwei;ZHANG Jianhao(Department of Radiology Interventional,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《实用放射学杂志》2024年第1期103-106,共4页Journal of Practical Radiology

基　　金：河南省医学科技攻关计划项目(SBGJ202002057)。

摘　　要：目的探讨介入治疗医源性阴道大出血的临床疗效及价值。方法回顾性分析妇产科术后阴道大出血患者35例,在数字减影血管造影(DSA)下行腹主动脉及双侧髂内动脉造影并栓塞出血动脉,记录相关临床数据并分析。结果33例患者经介入治疗后出血均在3d内基本停止,介入手术时间平均(57.5±17.2)min,妇产科术前与介入栓塞完成时血红蛋白值及红细胞压积、血压下降,心率升高比较明显,差异有统计学意义(P<0.05),介入栓塞完成时与介入术后72h的血红蛋白值及红细胞压积变化不明显,差异无统计学意义(P>0.05),血压升高及心率下降比较明显,差异有统计学意义(P<0.05),2例剖宫产患者介入栓塞治疗后止血效果欠佳,遂剖腹探查后行子宫切除术后出血停止。结论介入治疗具有创伤小、操作简便、疗效显著、不良反应少、恢复快等优点,在医源性阴道大出血的诊断及治疗上具有重要作用及临床价值。Objective To investigate the clinical efficacy and value of interventional treatment of iatrogenic massive vaginal bleeding.Methods Retrospective analysis was performed on 35 patients with postoperative vaginal massive hemorrhage in obstetrics and gynecology who were admitted.Abdominal aorta and bilateral internal iliac arteries angiography and embolization of abnormal vessels were performed under digital subtraction angiography(DSA),and relevant clinical data were recorded and analyzed.Results After interventional treatment,the vaginal bleeding of 33 patients basically stopped within 3 days,and the average interventional operation time was(57.5±17.2)min.The hemoglobin value,hematocrit and blood pressure decreased and the heart rate increased significantly before and after interventional embolization in obstetrics and gynecology,with statistical significance(P<0.05).There were no significant changes in hemoglobin value and hematocrit between the completion of interventional embolization and 72 hours after interventional embolization(P>0.05).The increase of blood pressure and the decrease of heart rate were statistically significant(P<0.05).Two patients with cesarean section had poor hemostatic effect after interventional embolization,and the bleeding stopped after exploratory laparotomy and hysterectomy.Conclusion Interventional treatment has the advantages of small trauma,simple operation,significant curative effect,few adverse reactions,and rapid recovery.It plays an important role and clinical value in the diagnosis and treatment of iatrogenic vaginal bleeding.

关 键 词：子宫动脉 失血 介入治疗 栓塞 

分 类 号：R711.73[医药卫生—妇产科学] R815[医药卫生—临床医学]