[1]周意明,翟仁友,姜蕾,等.超选择性动脉插管栓塞对产科大出血的治疗和预防[J].介入放射学杂志,2008,(03):211.
　ZHOU Yiming,ZHAI Renyou,JIANG Lei,et al.Super sclective transcatheter angiographic embolization：an effective and prophylactic treatment for massive obstetric haemorrhage[J].journal interventional radiology,2008,(03):211.
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超选择性动脉插管栓塞对产科大出血的治疗和预防()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2008年03期
页码:
211
栏目:
临床研究
出版日期:
2008-03-15

文章信息/Info

Title:
Super sclective transcatheter angiographic embolization：an effective and prophylactic treatment for massive obstetric haemorrhage
作者:
周意明; 翟仁友; 姜蕾; 钱晓军;  戴定可;  魏宝杰;  高 堃;  张世龙; 刘金梅; 张秋红
作者单位：100020北京首都医科大学附属朝阳医院放射科(周意明、翟仁友、钱晓军、魏宝杰、高垫、张世龙、刘金梅、张秋红)；卫生部北京医院放射科(姜蕾)
Author(s):
ZHOU Yi－ming; ZHAI Ren－you; JIANG Lei; QIAN Xiao－jun; DAI Ding－ke; WEI Bao－jie; GAO Kun; ZHANG Shi－long; LIU Jin－mei; ZHANG Qiu－hong．
Beijing Chaoyang Hospital，Capital University of Medical Sciences，Beijing１０００２０，China
关键词:
妊娠; 出血; 经导管动脉栓塞术; 子宫
分类号:
R７１４.４６１
文献标志码:
B
摘要:
目的探讨经导管动脉栓塞术（TAE）治疗和预防产科大出血的疗效及安全性。方法产科大出血或有大出血风险的病例１７例（其中已出现大出血病例１４例），包括产后或流产术后出血１０例，葡萄胎出血４例。３例预防性栓塞，包括胎盘前置２例，宫颈妊娠１例。选择性插管至双侧子宫动脉或髂内动脉，行DSA明确子宫血管情况，以直径１～３mm明胶海绵颗粒及明胶海绵条或聚乙烯醇（PVA）栓塞，部分病例经子宫动脉灌注甲氨喋呤（MTX）。结果插管成功率１００％，１４例大出血病例栓塞后活动性出血停止，手术成功，１～５d后阴道内完全无流血。３例预防性栓塞患者，栓塞后行引产术，１例发生大出血，２例未发生大出血。结论TAE创伤小，疗效快速肯定，且并发症少，对产科大出血是一种有效的治疗措施，对有大出血风险的病例预防应用可降低大出血或死亡的风险。

参考文献/References:

［１］Jaraquemada JM．Surgical training in selective pelvic arterial ligation or use of embolization only［J］．Am J Obstet Gynecol，２０００，１８２：２５２．
［２］戴家应，林根来，胡汉金，等．超选择性动脉插管栓塞治疗产科大出血［J］．介入放射学杂志，２００５，１４：３１０－３１２．
［３］Chung JW，Jeong HJ ，Joh JH，et al．Percutaneous transcatheter angiographic embolization in the management of obstetric hemorrhage［J］．J Reprod Med，２００３，４８：２６８－２７６．
［４］靳海英，金征宇．急诊子宫动脉栓塞术治疗产科大出血［J］．中华放射学杂志，２００１，３５：１１４－１１５．
［５］张勇，马瑛，王晓燕．介入栓塞术在剖宫产术后晚期子宫出血的应用［J］．实用放射学杂志，２００５，２１：１６１－１６２．［６］朱彬，朱锦桃，曹然．髂内动脉栓塞治疗产后大出血［J］．介入放射学杂志，２００６，１５：２１８－２２０．
［７］佟小强，邹英华，孙晓伟，等．微钢圈对急性出血性疾病的栓塞治疗作用［J］．中华放射学杂志，２００３，３７：１０８７－１０９１．
［８］Erdem M，Erdem A，Arslan M，et al．Single－dose methotrexate for the treatment of ectopic pregnancy［J］．Arch Gynecol Obstet，２００４，２７０：２０１－２０４．
［９］柯雪梅，朱康顺．盆腔血管性栓塞治疗的严重并发症分析［J］．介入放射学杂志，２００４，１３：３２０－３２１．
［１０］刘萍，陈春林，曾北蓝，等．子宫动脉栓塞治疗妇产科良性疾病引起泌尿系统损伤的临床研究［J］．中华妇产科杂志，２００６，４１：２５－２９．
［１１］Walker WJ ，McDowell SJ．Pregnancy after uterine artery embo－lization for leiomyomata：a series of５６completed pregnancies［J］．Am J Obstet Gynecol，２００６，１９５：１２６６－１２７１．
［１２］Carpenter TT，Walker WJ．Pregnancy following uterine artery embolisation for symptomatic fibroids：a series of２６completed pregnancies［J］．BJOG，２００５，１１２：３２１－３２５．
［１３］Goldberg J，Pereira L，Berghella V，et al．Pregnancy outcomes after treatment for fibromyomata：uterine artery embolization versus laparoscopic myomectomy ［J］．Am J Obstet Gynecol，２００４，１９１：１８－２１．
［１４］马奔，陈春林，曾北蓝，等．介入治疗中患者辐射剂量监测［J］．中华放射医学与防护杂志，２００２，２２：２１５－２１６．
［１５］黄欧平，张晓玲．妇产科血管性介入治疗的副反应和并发症［J］．实用妇产科杂志，２００５，２１：２０５－２０７．
［１６］Bloom AI ，Verstandig A，Gielchinsky Y，et al．Arterial embo－lisation for persistent primary postpartum haemorrhage：before or after hysterectomy？［J］．BJOG，２００４，１１１：８８０－８８４．
［１７］Ojala K，Perala J，Kariniemi J，et al．Arterial embolization and prophylactic catheterization for the treatment for severe obstetric hemorrhage［J］．Acta Obstet Gynecol Scand，２００５，８４：１０７５－１０８０．

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备注/Memo

备注/Memo:
收稿日期：２００７－０７－１９
更新日期/Last Update: 2008-03-15