难治性产后出血干预性治疗方法的对比研究  

A comparative study of surgical interventions used for the treatment of intractable postpartum hemorrhage

作　　者：黄瑾[1] 顾美皎[2] 方玲[1] 沈卓娜[1] 苏园园[1] 

机构地区：[1]中山市人民医院妇产科,528403 [2]华中科技大学同济医院附属同济医院妇产科,武汉430030

出　　处：《中国实用妇科与产科杂志》2004年第6期343-345,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨难治性产后出血的各种干预性措施在抢救过程中的合理应用及应用价值。方法　分析1 998年 1月至 2 0 0 3年 8月间 ,采用宫腔填塞纱布 (塞纱 )、盆腔动脉结扎、经导管动脉栓塞术等干预性措施的 88例难治性产后出血病人的临床资料。结果　全部抢救成功 ,其中 1 8例宫腔塞纱者成功 1 2例 (6 6 7% ) ,1 2例盆腔动脉结扎中成功 4例 (33 3% ) ,30例经导管动脉栓塞术 (TAE)治疗全部成功 (1 0 0 % ) ,4 2例一次开腹行全子宫切除术或加盆腔塞纱者成功 36例 (85 7% )。结论　宫腔塞纱可压迫止血。TAE可替代子宫切除术。当子宫成为凝血功能障碍的病因时 。Objective To assess the application of various surgical interventions used for the treatment of intractable postpartum hemorrhage.Methods From January 1998 to August 2003,88 patients with intractable postpartum hemorrhage were performed various interventions including uterine packing,bilateral hypogastric artery ligation (BHAL),transcatheter arterial embolization (TAE) and others.Results All patients were rescued successfully;12 out of 18(66 7%) undergoing uterine packing achieved success;BHAL was performed successfully in 4 out of 12(33\^3%),all of 30(100%) cases with TAE stopped bleeding,36 of 42(85 7%) cases receiving hysterectomy,or combining with pelvic packing,were treated successfully.Conclusion Uterine packing can arrest bleeding.TAE may be an effective alternative to hysterectomy.When uterine factors become the causes of disseminated intravascular coagulation (DIC),hysterectomy is necessary.

关 键 词：难治性产后出血 干预性治疗 宫腔填塞纱布 盆腔动脉结扎术 经导管动脉栓塞术 

分 类 号：R714.461[医药卫生—妇产科学]