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子宫动脉栓塞术治疗产后大出血的经验

[Experience with uterine artery embolization in the treatment of massive postpartum hemorrhage].

作者信息

Fornet I, Palacio F J, Morillas P, López M A, Ortiz-Gómez J R

机构信息

Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid.

出版信息

Rev Esp Anestesiol Reanim. 2008 Jan;55(1):21-5. doi: 10.1016/s0034-9356(08)70493-6.

Abstract

OBJECTIVE

To analyze our experience with uterine artery embolization in the management of massive hemorrhage in obstetric patients.

PATIENTS AND METHODS

This observational, retrospective study analyzed all deliveries requiring a blood transfusion that were performed in the maternity unit of Hospital Universitario La Paz between January 1, 2000 and December 31, 2005.

RESULTS

A total of 57,835 deliveries were performed with an incidence of postpartum hemorrhage of 0.7% (406 episodes). Uterine artery embolization was performed on 51 patients and 45 patients underwent obstetric hysterectomy. Both procedures were performed on 11 patients. Ten of the patients who underwent obstetric hysterectomy subsequently required uterine artery embolization, whereas only 1 patient required an obstetric hysterectomy following embolization because the hemorrhage was not resolved. The mean consumption of blood products for patients who underwent obstetric hysterectomy was twice that for patients who underwent uterine artery embolization. There were no complications secondary to embolization.

CONCLUSIONS

Uterine artery embolization is a safe and effective procedure for managing massive postpartum hemorrhage.

摘要

目的

分析我们在产科患者大出血管理中应用子宫动脉栓塞术的经验。

患者与方法

这项观察性回顾性研究分析了2000年1月1日至2005年12月31日在拉巴斯大学医院产科进行的所有需要输血的分娩病例。

结果

共进行了57835例分娩,产后出血发生率为0.7%(406例)。对51例患者实施了子宫动脉栓塞术,45例患者接受了产科子宫切除术。11例患者同时接受了这两种手术。接受产科子宫切除术的患者中有10例随后需要进行子宫动脉栓塞术,而在栓塞术后只有1例患者因出血未得到解决而需要进行产科子宫切除术。接受产科子宫切除术的患者的血液制品平均消耗量是接受子宫动脉栓塞术患者的两倍。栓塞术后无继发并发症。

结论

子宫动脉栓塞术是治疗产后大出血的一种安全有效的方法。

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