Park Ji Kwon, Shin Tae Bum, Baek Jong Chul, Shin Jeong Kyu, Choi Won Jun, Lee Soon Ae, Lee Jong Hak, Paik Won Young
Department of Obstetrics and Gynecology, School of Medicine, Gyeongsang National University, JinJu, Korea.
J Obstet Gynaecol Res. 2011 Aug;37(8):971-8. doi: 10.1111/j.1447-0756.2010.01463.x. Epub 2011 Apr 4.
We evaluated the efficacy of uterine artery embolization (UAE) for controlling postpartum hemorrhage (PPH).
Between January 2008 and December 2009, 23 women with intractable PPH underwent UAE. Specific diagnoses included uterine atony (n = 10), placenta accreta (n = 8), puerperal hematoma (n = 2) and placental polyp (n = 3).
Of 10 patients with uterine atony, treatment with UAE failed in two women with severe vasoconstriction. One patient developed lumbosacral plexopathy. All eight patients with placenta accreta were treated successfully with the placement of multiple sutures in the placental bed and UAE. Two of the three women with placental polyps were treated successfully with UAE and packing of the uterus.
Embolization should follow resuscitation for vascular collapse. In the case of an adherent placenta, embolization is more effective with the placement of multiple sutures in the placental bed or compression of the placental bed.
我们评估了子宫动脉栓塞术（UAE）控制产后出血（PPH）的疗效。
2008年1月至2009年12月期间，23例难治性PPH患者接受了UAE治疗。具体诊断包括宫缩乏力（n = 10）、胎盘植入（n = 8）、产褥期血肿（n = 2）和胎盘息肉（n = 3）。
10例宫缩乏力患者中，2例因严重血管收缩UAE治疗失败。1例患者发生腰骶丛神经病。所有8例胎盘植入患者通过在胎盘床放置多根缝线和UAE成功治疗。3例胎盘息肉患者中有2例通过UAE和子宫填塞成功治疗。
对于血管虚脱应先进行复苏再行栓塞术。对于粘连性胎盘，在胎盘床放置多根缝线或压迫胎盘床后进行栓塞术更有效。
