Negură A
Institut de Médecine et de Pharmacie, Iassy, Roumanie.
Rev Fr Gynecol Obstet. 1988 Apr;83(4):271-9.
The author studies haemostatic vascular ligations in obstetrics, in order to codify the indication of BLUA and BLHA in obstetrical haemorrhages uncontrollable with classic therapeutic means. He comes to the following conclusions: in severe post-partum haemorrhages defined by a hypotonic uterus and resistant to classic therapy, BLUA is a simple, fast, harmless procedure when carried out on the ascending branches and providing a favorable result; in severe post-partum haemorrhages originating in the segmento-cervical area, one may resort: either to BLHA; or the BLUA, at their origin (but information is not yet available concerning clinical experiment). In severe haemorrhages originated in the parauterine areas, or the hypogastric arterial system, only BLHA may be effective; in severe obstetrical haemorrhages caused by coagulation disorders and untractable with classic methods, BLHA may be useful and prevent a haemostatic hysterectomy or a least decreases bleeding intra- or even post-operatively.
作者研究了产科中的止血性血管结扎术,以便对在经典治疗方法无法控制的产科出血中使用子宫动脉上行支结扎术(BLUA)和子宫动脉高位结扎术(BLHA)的适应症进行编纂。他得出以下结论:在因子宫收缩乏力且对经典治疗有抵抗性而导致的严重产后出血中,当对子宫动脉上行支进行结扎时,BLUA是一种简单、快速且无害的手术,并能取得良好效果;在源自宫颈段区域的严重产后出血中,可以采用:要么进行BLHA;要么在其起始处进行BLUA(但尚无关于临床试验的信息)。在源自子宫旁区域或腹下动脉系统的严重出血中,只有BLHA可能有效;在由凝血障碍引起且经典方法难以治疗的严重产科出血中,BLHA可能有用,并可避免进行止血性子宫切除术,或者至少减少术中甚至术后的出血。