2018子宫动脉栓塞介入治疗在基层医院妇产科出血性疾病中的临床应用
摘 要 目的:探析子宫动脉栓塞介入治疗在基层医院妇产科出血性疾病中的临床应用。方法:选择58例妇产科出血性疾病患者均给予子宫动脉栓塞介入治疗,对其栓塞结果、临床疗效以及不良反应情况进行观察分析。结果:临床有效率为96.6%,其中痊愈46例、有效10例、无效2例。术后子宫造影显示子宫动脉末梢及中远段均消失;治疗后患者的血压、心率、血红蛋白等指标均明显优于栓塞前(P http://关键词 子宫动脉栓塞 介入治疗 出血性疾病
中图分类号:R713.4 文献标识码:B 文章编号:1006-1533(2017)23-0039-03
Application of interventional uterine artery embolization in hemorrhagic disorders at obstetrics and gynecology of primary hospital
DENG Chengqing, TANG Rui
(Department of Radiology and Invasive Technology, the People’s Hospital of Sheyang County, Yancheng 224300, China)
ABSTRACT Objective: To explore the application of interventional uterine artery embolization in hemorrhagic disorders at obstetrics and gynecology of primary hospital. Methods: Fifty-eight cases with hemorrhagic disorders were selected and underwent interventional uterine artery embolization, and the effects and adverse reactions were analyzed. Results: The clinical effective rate was 96.6%, in which there were 46 cases cured, 10 cases effect and 2 cases failed. Postoperative uterine angiography showed that peripheral and mid-distal of uterine artery were all disappeared. The indexes such as blood pressure, heart rate, hemoglobin were better after treatment than before (P 1.2 治疗方法
所用仪器为西门子AXIDM Artisu型DSA(数字减影血管造影机)。患者均已给予常规抗休克治疗。手术时常规消毒患者的腹股沟区,给予1%利多卡因局麻,Seldinger法穿刺右侧股动脉,并进行DSA拍摄,查找到出血动脉之后常规使用明胶海绵颗粒进行栓塞治疗,栓塞后进行造影复查,若靶血管血流明显受阻,其末梢分支未显示,则提示手术操作成功。术毕对穿刺点进行加压包扎,患者术后24 h平卧,下肢给予制动8 h,常规抗生素抗感染治疗,同时给予输液、补血等治疗。密切观察患者术后有无活动性出血,监测血压、心率、血红蛋白等指标。
1.3 观察项目
术后对患者的栓塞结果(栓塞成功率和监测指标等)、临床疗效及不良反应情况进行观察分析。临床疗效标准:①治愈:患者术后无活动性出血,随访未复发;②有效:患者术后活动性出血减少;③无效:患者活动性出血情况经栓塞介入治疗后未能控制,尚需进一步手术治疗。
1.4 统计学方法
2 结果
2.1 栓塞术手结果
58例患者均成功进行子宫动脉栓塞介入治疗,术后造影显示子宫动脉末梢及中远段均消失;与治疗前相比,治疗后患者的血压、心率、血红蛋白等指标均明显优于栓塞前(P参考文献
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