髂内动脉栓塞制止致命性阴道出血

来源 :国外医学.妇产科学分册 | 被引量 : 0次 | 上传用户:zgm_19780916
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晚期妇科恶性肿瘤病人有致命性阴道出血时,只能对症治疗。当所有常用方法用尽后,病人有失血、死亡的危险,此时病人已处于休克状态,故较大手术如髂内动脉结扎亦不能考虑。由于选择性动脉造影的重大进展,有可能应用放射学方法寻找出血源,然后用生物学自体的或合成的物质栓塞出血区的供血动脉以阻止出血。资料和方法:近2年来有5例作了髂内动脉栓塞,其中3例是宫颈癌Ⅲ_b期;1例是晚期直肠阴道隔腺癌,原发灶定位不明;另一例为宫颈癌Ⅱ_b期根治术后并发致命性出血。此5例皆在栓塞前保守治疗无效。髂内动脉栓塞按Seldinger方法进行,局麻下经皮将导丝通过穿刺针放入股动脉,在X线检查下将聚乙烯导管套于导丝外进入股动脉。不同形状的导管(眼镜蛇式导管、侧缠络导管)可在同侧或对 Late gynecological malignant tumor patients have fatal vaginal bleeding, can only symptomatic treatment. When all the commonly used methods are exhausted, the patient has the risk of blood loss and death. At this time, the patient is in a state of shock. Therefore, larger surgery such as ligation of the internal iliac artery can not be considered. Due to the significant advances in selective arteriography, it is possible to apply radiographic methods to find the source of the hemorrhage and then embolize the donor arteries in the hemorrhage area with biological autologous or synthetic substances to stop the bleeding. Materials and Methods: In the past 2 years, 5 cases had internal iliac artery embolization, of which 3 cases were stage Ⅲ_b cervical cancer; 1 case was rectovaginal adenocarcinoma of the rectum, the location of the primary tumor was unknown; another case was stage Ⅱ_b cervical cancer Postoperative fatal bleeding. All 5 cases were ineffective in the conservative treatment before embolization. Internal iliac artery embolization by Seldinger method, under local anesthesia guide wire through the needle into the femoral artery, under the X-ray examination of polyethylene catheters outside the guide wire into the femoral artery. Different shapes of catheters (cobra catheters, side entangled catheters) can be on the same side or on the right
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