子宫动静脉畸形,子宫动脉栓塞术,异常子宫出血," /> 子宫动静脉畸形,子宫动脉栓塞术,异常子宫出血,"/> Uterine arteriovenous malformation,Embolization, uterine artery,Abnormal uterine bleeding,"/> <span style="font-size:14px;line-height:2;">子宫动静脉畸形1例及文献复习</span>
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发育医学电子杂志  2017, Vol. 5 Issue (2): 105-109    
  围产医学   临床经验交流 |产科 |
子宫动静脉畸形1例及文献复习
廖德华 宋晓磊 谢梅青
中山大学孙逸仙纪念医院 普通妇科,广东 广州 510030
Uterine arteriovenous malformation: a case report and review of the literatures
LIAO De-hua,SONG Xiao-lei, XIE Mei-qing
Department of Gynecology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong, Guangzhou 510030, China
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摘要 目的  探讨子宫动静脉畸形的临床特征及诊治方法。 方法 2016年4月,中山大学孙逸仙纪念医院收治1例“反复阴道流血4个月余”的子宫动静脉畸形患者,分析其临床诊治经过,并查阅文献,分析子宫动静脉畸形的病因、临床表现、辅助检查及治疗方法。结果 患者因“妊娠8+周,稽留流产”行清宫术后反复阴道流血4个月余。B超显示宫内无回声区45 mm×42 mm,其内及周边血流丰富;CT显示子宫右前壁病灶区域动脉期见显著强化,提示子宫动静脉畸形可能,行选择性双侧子宫动脉栓塞术。出院后8周后月经来潮,经量如常。结合文献报道,阴道流血是子宫动静脉畸形的常见临床表现,彩色多普勒超声是重要的辅助检查手段,部分病例可采用MRI和CT帮助诊断,数字减影血管造影是诊断的金标准。治疗方案应个体化,根据病情采用密切随访、宫腔置入Foley球囊压迫止血、药物治疗、子宫动脉栓塞术、子宫动脉结扎术、子宫切除术等方法。 结论 对突发大量阴道流血的患者,应考虑到子宫动静脉畸形,争取早期诊断,个体化选择治疗方案,改善预后。
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关键词:  子宫动静脉畸形')" href="#">">子宫动静脉畸形  子宫动脉栓塞术  异常子宫出血    
Abstract: Objective To explore the clinical characteristics, diagnosis and treatment methods of uterine arteriovenous malformation. Methods A woman who complained repeated vaginal bleeding for four months was admitted to Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University in April, 2016. The diagnosis and treatment of this case were analyzed. Relevant literatures were reviewed to analyze the etiology, clinical manifestations, examination and treatment of uterine arteriovenous malformation. Results A 37-year-old woman presented repeated vaginal bleeding for four months after curettage for missed abortion at the 8+ weeks of pregnancy. An anechoic area of 45 mm×42 mm with rich blood flow was detected by ultrasound. CT scan showed arterial enhancement in the lesion of right front wall of the uterine, suggesting uterine arteriovenous malformation. Selective uterine artery embolization was performed for the patient. The menstruation recovered as usual after 8 weeks from discharged. According to the literatures, vaginal bleeding was a common clinical symptom of uterine arteriovenous malformation. Color Doppler ultrasound was important examination, while MRI and CT could help to diagnose in some cases. Angiography was the golden standard. The treatment regimen should be individualized. Close follow-up, compressing hemostasis by placement of intrauterine Folley balloon, medicine therapy, embolization of uterine artery, ligation of uterine artery, uterine hysterectomy and other treatment could be considered according to different conditions. Conclusions Uterine arteriovenous malformation should be considered for women with acute serious vaginal bleeding. Early diagnosis and treatment individually can improve prognosis.
Key words:  line-height:2    Uterine arteriovenous malformation')" href="#">">Uterine arteriovenous malformation    Embolization, uterine artery    Abnormal uterine bleeding
收稿日期:  2016-11-20                出版日期:  2017-04-30      发布日期:  2018-01-17      期的出版日期:  2017-04-30
通讯作者:  谢梅青:女,主任医师,妇科主任,硕士研究生导师,中山大学孙逸仙纪念医院妇科主任。     E-mail:  mqxiegz@163.com
引用本文:    
廖德华 宋晓磊 谢梅青. 子宫动静脉畸形1例及文献复习[J]. 发育医学电子杂志, 2017, 5(2): 105-109.
LIAO De-hua, SONG Xiao-lei, XIE Mei-qing . Uterine arteriovenous malformation: a case report and review of the literatures. Journal of Developmental Medicine(Electronic Version), 2017, 5(2): 105-109.
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