The Research Of Intravascular Interventional Treatment For Postpartum Hemorrhage Of Research

Objective: To evaluate the efficacy and complication of intravascular interventional therapy for postpartum hemorrhage.Methods: To select cases of postpartum hemorrhage between 2013.1 and 2015.2 who were failured by conservation managements(such as drugs, uterine tamponade, B- lynch sun back suture of the uterus, artery ligation, etc) and taken intravascular interventional embolization after explicit the bleeding vessel by DSA. Observed and made a record of blood pressure,heart rate and hemoglobin before and after embolization to evaluate the efficacy. Observed postoperative complications(fever, pain,etc).Results: A total of 38 patients during 2013.1 and 2015.2 who had been diagnosed with postpartum hemorrhage and failured by conservation managements with intravascular embolization treatment were collected. 38 patients had different degrees of uterine artery circuity enlargement, some cases of local contrast spillover or contrast agents "vascular lake" thick phenomenon, including 2 cases of patients with ovarian artery, 1 cases with lumbar artery and external iliac arterial blood supply, all successful completion of the blood supply artery embolism, technical success rate was 100%. After embolization 27 cases immediately stopped bleeding, 11 cases decreased significantly and bleeding stopped completely in one week, no one underwent hysterectomy, success rate was 100%.Blood pressure(systolic pressure127.42±14.08 mm Hg, diastolic blood pressure79.63±9.96 mm Hg) and heart rate(83.50±10.00 times/min)stability returned immediately after embolization, compared with preoperative(systolic pressure 114.58±17.77 mm Hg, diastolic blood pressure 73.61±13.89 mm Hg, heart rate 96.42±18.90 times/min),with significant difference(P< 0.05).Postoperative monitoring(106.08±16.62 g/L)has significant difference compared with preoperative hemoglobin(90.45±22.11g/L)(P<0.05).17 patients appeared different degree of postoperative fever, temperature between 37.3 ~39.0 ℃, 2 cases of patients with abdominal pain, 1 case of patients with lower limb muscle pain, hip pain, after treatment for symptomatic relief, the rest had no serious complications.Conclusion: 1.Intravascular interventional therapy for after invalid conservative treatment of postpartum hemorrhage can achieve rapid and effective hemostatic effect, postoperative vital signs(blood pressure, heart rate, hemoglobin) are obviously improved compared with thepreoperative, and less complications.2. Usually, embolization of bilateral uterine artery can achieve excellent hemostatic effect.However, ovary artery and other pelvic arteries also take part in uterine blood supplement.Therefore, we need to make abdominal aorta angiography and assessment before embolization; if repeated bleeding after uterine artery embolization, should pay attention to other artery blood supply situation, and take into consideration the embolization.