流产后出血的子宫动脉栓塞术
Uterine artery embolization in postabortion hemorrhage.
作者信息
Steinauer Jody E, Diedrich Justin T, Wilson Mark W, Darney Philip D, Vargas Juan E, Drey Eleanor A
机构信息
Bixby Center for Reproductive Health Research and Policy, and San Francisco General Hospital, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, California, USA.
出版信息
Obstet Gynecol. 2008 Apr;111(4):881-9. doi: 10.1097/AOG.0b013e3181685780.
OBJECTIVE
To summarize the efficacy of postabortion uterine artery embolization in cases of refractory hemorrhage.
METHODS
Forty-two women were identified who had postabortion uterine artery embolization at San Francisco General Hospital between January 2000 and August 2007. Seven underwent embolization for hemorrhage caused by abnormal placentation.
RESULTS
Embolization was successful in 90% (38 of 42) of cases. All failures (n=4) were in patients who had confirmed abnormal placentation. However, three of seven women (43%) with probable accreta diagnosed by ultrasonography were treated successfully with uterine artery embolization. Two patients experienced complications of uterine artery embolization. These complications-one contrast reaction and one femoral artery embolus-were treated without further sequelae.
CONCLUSION
Uterine artery embolization is an alternative to hysterectomy in patients with postabortion hemorrhage refractory to conservative measures, especially when hemorrhage is caused by uterine atony or cervical laceration.
目的
总结流产后子宫动脉栓塞术治疗难治性出血的疗效。
方法
确定了2000年1月至2007年8月间在旧金山总医院接受流产后子宫动脉栓塞术的42名女性。其中7名因胎盘异常植入导致出血而接受栓塞治疗。
结果
栓塞术在90%（42例中的38例）的病例中成功。所有失败病例（n = 4）均为确诊胎盘异常植入的患者。然而，超声诊断可能存在胎盘植入的7名女性中有3名（43%）通过子宫动脉栓塞术成功治疗。2名患者出现子宫动脉栓塞术的并发症。这些并发症——1例造影剂反应和1例股动脉栓子——经治疗后未留下进一步后遗症。
结论
对于保守治疗无效的流产后出血患者，尤其是出血由子宫收缩乏力或宫颈裂伤引起时，子宫动脉栓塞术是子宫切除术的一种替代方法。
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