本文選題：子宮動(dòng)脈瘤 + 經(jīng)陰分娩�。� 參考：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》2017年05期

【摘要】：目的:子宮動(dòng)脈瘤多被認(rèn)為與產(chǎn)程中創(chuàng)傷性操作相關(guān),但近年陸續(xù)有報(bào)道顯示子宮動(dòng)脈瘤可發(fā)生于自然分娩過(guò)程中。本文將為自然分娩過(guò)程中子宮動(dòng)脈瘤的發(fā)生和緊急處理等提供參考指導(dǎo)。創(chuàng)新點(diǎn):產(chǎn)前出血可能是子宮動(dòng)脈瘤發(fā)生的潛在危險(xiǎn)信號(hào)。方法:病例報(bào)道和文獻(xiàn)匯納分析�；颊吲�,37歲,疤痕子宮,臨產(chǎn)入院,產(chǎn)前出血,經(jīng)陰順產(chǎn)后12 h,突發(fā)陰道大量出血,常規(guī)對(duì)癥處理(按摩子宮、陰道填塞、縮宮素靜滴和欣母佩宮頸注射等)未能有效緩解,40 min內(nèi)出血達(dá)1800 ml。床邊B超未提示動(dòng)脈瘤特征,數(shù)字減影血管造影(DSA)顯示左側(cè)子宮動(dòng)脈瘤,即刻予動(dòng)脈栓塞成功止血�；颊弋a(chǎn)后4 d無(wú)并發(fā)癥出院,隨訪無(wú)后遺癥。結(jié)論:臨床醫(yī)師需要加強(qiáng)對(duì)子宮動(dòng)脈瘤發(fā)生的警惕認(rèn)識(shí)和急救處理水平。子宮動(dòng)脈瘤和產(chǎn)程中的有創(chuàng)性操作無(wú)必然相關(guān)性,疤痕子宮的產(chǎn)前出血可能是子宮動(dòng)脈瘤發(fā)生的潛在危險(xiǎn)信號(hào),產(chǎn)后隨訪應(yīng)提高對(duì)晚期出血發(fā)生的警惕性。鑒于B超在診斷動(dòng)脈瘤方面的有限性,高度懷疑動(dòng)脈瘤時(shí)應(yīng)盡快行血管造影明確診斷,及時(shí)栓塞處理。
[Abstract]:Objective: uterine aneurysms are thought to be related to traumatic operation during labor, but there have been reports in recent years that uterine aneurysms can occur during natural labor.This article will provide reference for the occurrence and emergency management of uterine aneurysm during natural delivery.Innovation: prenatal bleeding may be a potential risk signal for uterine aneurysms.Methods: case report and literature analysis.The patient was 37 years old, with scar uterus, parturient, prenatal bleeding, 12 hours after vaginal delivery, sudden massive vaginal bleeding, routine treatment (massage uterus, vaginal tamponade, vaginal tamponade, vaginal tamponade),The intrauterine bleeding of 40 min could not be effectively alleviated by oxytocin intravenous drip and cervix injection.The left uterine aneurysm was demonstrated by digital subtraction angiography (DSAA) without any sign of aneurysm on the side of the bed. The embolization of the left uterine artery was performed immediately.There were no complications and no sequelae after 4 days postpartum.Conclusion: clinicians should strengthen their awareness of the occurrence of uterine aneurysms and the level of emergency treatment.There is no necessary correlation between invasive operation of uterine aneurysm and labor process. Prenatal bleeding of scar uterus may be a potential risk signal for the occurrence of uterine aneurysm. Postpartum follow-up should increase vigilance against late bleeding.In view of the limitation of B-ultrasound in the diagnosis of aneurysms, angiography should be performed as soon as possible, and embolization should be carried out as soon as possible when the aneurysms are highly suspected.
【作者單位】： Department
【基金】：supported by the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality(No.16ZR1420000),China
【分類號(hào)】：R714.2

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