臨床婦人科産科73巻9号

2019年09月発行

今月の臨床 産科危機的出血のベストマネジメント―知っておくべき最新の対応策 緊急対処法

産科危機的出血に対する緊急IVRの適応と合併症

著者： 宇賀麻由¹ 平木隆夫¹ 金澤右¹

所属機関： ¹岡山大学放射線科

ページ範囲：P.846 - P.853

●産科出血は出血が持続すれば容易にDICに陥るので，治療方針の迅速な決定が必要である．

●出血源が明らかであれば選択的に塞栓を行い，選択的に塞栓できない場合や出血源が明らかでなければ両側子宮動脈を塞栓するのが基本である．骨盤内血管には豊富な吻合が存在することを認識する．

●500μm以下の塞栓物質は子宮内膜壊死をきたすリスクがあるため使用しない．

●DICに陥っている場合には，液体塞栓物質（NBCA）での塞栓が必要になることがある．

参考文献

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