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目的探讨子宫动脉栓塞在预防和治疗子宫出血中的应用价值。方法对12例剖宫产后、8例人工流产术后出血的一组患者行双侧子宫动脉栓塞术(出血组),其中有3例栓塞髂内动脉前干;对5例瘢痕妊娠、3例宫颈妊娠及7例前置胎盘的一组患者引产术前行预防性双侧子宫动脉栓塞术(预防组)。结果两组35例栓塞手术全部成功,子宫出血患者除1例无效行子宫切除外,其余即刻止血;预防出血栓塞的患者,引产时术中出血量少于30 ml,无明显出血。两组患者均无严重并发症发生。随访2~6个月无再出血,40~120天后月经恢复正常。结论子宫动脉栓塞术止血迅速、疗效确切,可以保留患者的子宫和生育功能,尤其是预防性栓塞能达到预期目的。
Objective To investigate the value of uterine artery embolization in the prevention and treatment of uterine bleeding. Methods A total of 12 cases of cesarean section and 8 cases of postoperative bleeding induced by artificial abortion were treated by bilateral uterine arterial embolization (bleeding group), including 3 cases of anterior internal iliac artery embolization. Five cases of scar pregnancy, 3 A group of patients with cervical pregnancy and 7 placenta previa led to prophylactic bilateral uterine artery embolization (prophylaxis group). Results All the 35 cases of embolization were successful in both groups. Except for 1 case of uterine bleeding, the patients were stopped bleeding immediately. In the prevention of thromboembolism, the blood loss during operation was less than 30 ml and there was no obvious bleeding. No serious complications occurred in both groups. Follow-up 2 to 6 months without further bleeding, 40 to 120 days after menstruation returned to normal. Conclusion Uterine artery embolization is rapid and effective, and can preserve the uterus and reproductive function of patients, especially the preventive embolization can achieve the expected purpose.