产后大出血发病因素及动脉栓塞治疗效果分析  

Analysis on pathogenic factors of postpartum hemorrhage and effect of arterial embolization

作　　者：李宏 闫星妹 董永安[2] 

机构地区：[1]西电集团医院妇产科,陕西西安710077 [2]陕西省人民医院介入放射科,陕西西安710038

出　　处：《中国计划生育和妇产科》2015年第3期34-37,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨产后大出血发病因素及采用动脉栓塞治疗的效果。方法选择2012~2013年西电集团医院与陕西省人民医院收治的320例产妇的临床资料,其中采用栓塞治疗的产后大出血产妇120例,产科分娩、未发生产后大出血的产妇200例为对照,分析产后大出血的发病因素及栓塞治疗的预后情况。结果 120例产后大出血产妇中,58例为阴道动脉出血,42例为子宫动脉出血,20例为阴部内动脉出血。不同动脉出血产妇的止血成功率、栓塞时间、输血量与住院时间比较差异均无统计学意义（P〉0.05）。Logistic回归模型结果显示新生儿体重、孕次≥3次、二次剖宫产、胎盘前置、胎盘植入、子宫收缩乏力、是产后大出血的主要危险因素（P〈0.05）。结论影响产后大出血的因素是多样化的,应积极进行综合预防。产后大出血产妇选择动脉栓塞治疗具有手术时间短、恢复快、效果肯定且可保留子宫等优点。Objective To investigate pathogenic factors of postpartum hemorrhage and effect of arterial embolization. Methods Data of 320 puerperas in XD Group Hospital and Shanxi Provincial People＇s Hospital from 2012 to 2013 were collected,120 cases with postpartum hemorrhage were treated with artery embolization,200 cases with non postpartum hemorrhage of obstetric delivery were selected as control group. The pathogenic factors of postpartum hemorrhage and prognosis of arterial embolization were analyzed.Results Of the 120 cases with postpartum hemorrhage,58 cases were vaginal artery hemorrhage,42 cases were uterine artery hemorrhage,20 cases were internal pudendal artery hemorrhage. The success rate of hemostasis,embolization time,blood transfusion volume and hospitalization time in the different artery hemorrhage groups had no significant difference（ P〉0. 05）. The logistic regression showed that the birth weight, gestational times ≥ 3 times, secondary cesarean section, placenta previa, placenta implantation,uterine inertia were the major risk factors of postpartum hemorrhage（ P〈0. 05）. Conclusion The influencing factors of postpartum hemorrhage are diverse which need comprehensive prevention. The arterial embolization for postpartum hemorrhage has the advantages of shorter operation time and recover time,confirm effect,etc.

关 键 词：产后大出血 动脉栓塞 发病因素 止血效果 

分 类 号：R714.461[医药卫生—妇产科学]