Soncini E, Pelicelli A, Larini P, Marcato C, Monaco D, Grignaffini A
Department of Gynecology, Obstetrics and Neonatology, University of Parma, Italy.
Int J Gynaecol Obstet. 2007 Mar;96(3):181-5. doi: 10.1016/j.ijgo.2006.12.010. Epub 2007 Feb 6.
The study was conducted to evaluate the efficacy of superselective transcatheter uterine artery embolization for control of obstetric hemorrhage.
Between January 2002 and December 2005, 14 consecutive patients underwent uterine artery embolization to control postpartum hemorrhage, and two to prevent hemorrhage before second-trimester therapeutic abortion.
Embolization was performed by transfemoral arterial catheterization. Pieces of absorbable gelatin sponge were used in all cases, with the addition of platinum coils in two cases for complete vessel occlusion. Optimal bleeding control was achieved in all cases but one--a patient who underwent hysterectomy due to embolization failure. No severe complications were observed.
The high success rate, low morbidity rate, and possibility of preserving reproductive function have made superselective uterine artery embolization the technique of choice to control life-threatening, intractable postpartum hemorrhage in hemodynamically stable patients, provided multidisciplinary medical teams are promptly available.
本研究旨在评估超选择性经导管子宫动脉栓塞术控制产科出血的疗效。
2002年1月至2005年12月期间,14例连续患者接受子宫动脉栓塞术以控制产后出血,另有2例在孕中期治疗性流产前预防出血。
通过经股动脉插管进行栓塞。所有病例均使用可吸收明胶海绵碎片,其中2例加用铂金线圈以实现血管完全闭塞。除1例因栓塞失败而接受子宫切除术的患者外,所有病例均实现了最佳出血控制。未观察到严重并发症。
高成功率、低发病率以及保留生殖功能的可能性,使得超选择性子宫动脉栓塞术成为控制血流动力学稳定患者危及生命的难治性产后出血的首选技术,前提是能迅速组建多学科医疗团队。