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经导管动脉栓塞术治疗产后出血:适应证、技术、结果及并发症

Transcatheter Arterial Embolization for Postpartum Hemorrhage: Indications, Technique, Results, and Complications.

作者信息

Soyer Philippe, Dohan Anthony, Dautry Raphael, Guerrache Youcef, Ricbourg Aude, Gayat Etienne, Boudiaf Mourad, Sirol Marc, Ledref Olivier

机构信息

Department of Abdominal and Interventional Imaging, Hôpital Lariboisière-AP-HP, 2 rue Ambroise Paré, 75475, Paris Cedex 10, France.

Diderot-Paris 7, Université-Sorbonne Paris-Cité, 10 Avenue de Verdun, 75010, Paris, France.

出版信息

Cardiovasc Intervent Radiol. 2015 Oct;38(5):1068-81. doi: 10.1007/s00270-015-1054-y. Epub 2015 Feb 13.

Abstract

Postpartum hemorrhage (PPH) is a potentially life-threatening condition, which needs multidisciplinary management. Uterine atony represents up to 80 % of all causes of PPH. Transcatheter arterial embolization (TAE) has now a well-established role in the management of severe PPH. TAE allows stopping the bleeding in 90 % of women with severe PHH, obviating surgery. Pledgets of gelatin sponge as torpedoes are commonly used for safe TAE, and coils, glue, and microspheres have been primarily used in specific situations such as arterial rupture, pseudoaneurysm, and arteriovenous fistula. TAE is a minimally invasive procedure with a low rate of complications, which preserves future fertility. Knowledge of causes of PPH, potential risks, and limitations of TAE is essential for a timely decision, optimizing TAE, preventing irreversible complications, avoiding hysterectomy, and ultimately preserving fertility.

摘要

产后出血(PPH)是一种可能危及生命的病症,需要多学科管理。宫缩乏力占所有产后出血原因的80%。经导管动脉栓塞术(TAE)目前在严重产后出血的管理中具有明确的作用。TAE能使90%的严重产后出血女性止血,从而避免手术。作为栓塞剂的明胶海绵条通常用于安全的TAE,而弹簧圈、胶水和微球主要用于动脉破裂、假性动脉瘤和动静脉瘘等特定情况。TAE是一种并发症发生率低的微创手术,可保留未来生育能力。了解产后出血的原因、TAE的潜在风险和局限性对于及时做出决策、优化TAE、预防不可逆并发症、避免子宫切除术以及最终保留生育能力至关重要。

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