将动脉栓塞作为一线止血疗法治疗外阴阴道血肿。
Managing vulvovaginal hematoma by arterial embolization as first-line hemostatic therapy.
作者信息
Takagi Kenjiro, Akashi Keiko, Horiuchi Isao, Nakamura Eishin, Samejima Koki, Ushijima Junko, Okochi Tomohisa, Hamamoto Kohei, Tanno Keisuke
机构信息
Perinatal Center, Division of Maternal and Fetal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Perinatal Center, Division of Maternal and Fetal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan.
出版信息
Taiwan J Obstet Gynecol. 2017 Apr;56(2):224-226. doi: 10.1016/j.tjog.2016.03.009.
OBJECTIVE
A puerperal vulvovaginal hematoma may continue to grow after a surgical procedure and may require blood transfusion. Thus, we selected arterial embolization for hemostasis as the first-line management in two cases of large vulvovaginal hematoma.
MATERIALS AND METHODS
Case 1 was a 32-year-old pregnant woman. After delivery, a 10-cm vulvar hematoma developed. An enhanced computed tomography (CT) scan revealed active bleeding. Arterial embolization was performed and complete hemostasis was obtained. Case 2 was a 34-year-old woman with a recurring hematoma after delivery. An enhanced CT scan revealed extravasation in the hematoma. Gelatin sponges were applied and complete hemostasis was obtained. In both cases, arterial embolization was successful without requiring blood transfusions.
RESULTS AND CONCLUSION
We successfully managed two cases of puerperal vulvovaginal hematoma by arterial embolization based on the evaluation of an enhanced CT scan. In conclusion, we suggest arterial embolization to be a viable option for first-line treatment in the management of vulvovaginal hematomas.
目的
产后外阴阴道血肿在手术后可能会持续增大，可能需要输血。因此，我们选择动脉栓塞止血作为两例大型外阴阴道血肿的一线治疗方法。
材料与方法
病例1为一名32岁的孕妇。分娩后出现了一个10厘米的外阴血肿。增强计算机断层扫描（CT）显示有活动性出血。进行了动脉栓塞，实现了完全止血。病例2为一名34岁的女性，产后血肿复发。增强CT扫描显示血肿内有造影剂外渗。应用了明胶海绵，实现了完全止血。在这两个病例中，动脉栓塞均成功，无需输血。
结果与结论
基于增强CT扫描的评估，我们通过动脉栓塞成功治疗了两例产后外阴阴道血肿。总之，我们建议动脉栓塞是外阴阴道血肿管理中一线治疗的可行选择。
Zotero 插件