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经导管动脉栓塞治疗子宫切除术后严重继发性出血。

Transcatheter Arterial Embolization for Severe Secondary Hemorrhage after Hysterectomy.

机构信息

Women's Cancer Clinic, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

J Minim Invasive Gynecol. 2018 Jan;25(1):180-185. doi: 10.1016/j.jmig.2017.06.028. Epub 2017 Jul 13.

Abstract

Four of 1237 patients who underwent abdominal, laparoscopic, and vaginal hysterectomy between October 2013 and May 2015 had severe secondary hemorrhage after hysterectomy (2 conventional multiport total laparoscopic hysterectomies, 1 single-port access hysterectomy, and 1 total abdominal hysterectomy). The median time interval between hysterectomy and secondary hemorrhage was 28.4 days (range, 16-52 days). All 4 cases were treated with transcatheter arterial embolization (TAE), all of whom required blood transfusions to maintain vital functions before TAE. The mean operative time was 90 minutes. The median length of hospital stay after TAE was 12 days (range, 4-24 days), and the patients were discharged without complications or additional surgery. These cases show the value of minimally invasive TAE for patients experiencing severe secondary hemorrhage after hysterectomy.

摘要

2013 年 10 月至 2015 年 5 月期间,1237 名接受腹部、腹腔镜和阴道子宫切除术的患者中,有 4 名在子宫切除术后发生严重继发性出血(2 例常规多孔全腹腔镜子宫切除术、1 例单孔入路子宫切除术和 1 例全腹部子宫切除术)。子宫切除术后至继发性出血的中位时间间隔为 28.4 天(范围,16-52 天)。所有 4 例均采用经导管动脉栓塞术(TAE)治疗,所有患者在 TAE 前均需要输血以维持生命功能。平均手术时间为 90 分钟。TAE 后中位住院时间为 12 天(范围,4-24 天),患者无并发症或额外手术出院。这些病例表明,对于子宫切除术后发生严重继发性出血的患者,微创 TAE 具有重要价值。

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