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作者对5例软产道裂伤及腹膜后血肿的顽固性产后出血产妇在保守止血法无效的情况下,转而采用选择性损伤动脉栓塞术获得成功。本法由定位损伤动脉及栓塞两步骤组成。具体方法为用1%利多卡因皮下浸润麻醉于左腹股沟处后,行左股动脉穿刺,插入行血管造影的导管,逆行向上经髂总动脉到达右髂内动脉,行动脉造影。可见到造影剂由损伤动脉处漏出。再借助该导管在透视下将栓塞剂与造影剂同时注入,使损伤的动脉栓塞达到止血目的。栓塞剂为将20×30×7 mm大小的明胶海绵切成1～2mm的碎片。造影剂为60%meglumin sodium amidotrizoate 10ml。
The author of 5 cases of soft birth canal laceration and retroperitoneal hematoma refractory postpartum hemorrhage in the conservative hemostasis ineffective in favor of selective injury to the success of arterial embolization. This method consists of positioning the damaged artery and embolization two steps. Specific method is to use 1% lidocaine subcutaneous infiltration under the anesthesia in the left groin, the line of the left femoral artery puncture, angiography catheter inserted into the retrograde upward through the common iliac artery to the right internal iliac artery, arterial angiography. Visible contrast agent leaks from the damaged artery. With the aid of this catheter, the embolizing agent and the contrast agent are simultaneously injected under fluoroscopy, so that the damaged arterial embolization can achieve the purpose of hemostasis. Embolization agent is a 20 × 30 × 7 mm size gelatin sponge cut into 1 ~ 2mm fragments. Contrast medium is 60% meglumin sodium amidotrizoate 10ml.