子宫动脉栓塞术治疗难治性产后出血36例临床分析  

Clinical analysis of uterine artery embolization in the treatment of intractable postpartum hemorrhage in 36 cases

作　　者：杨庆雪[1] 周梅玲[1] 

机构地区：[1]南阳医学高等专科学校第二附属医院妇产科,河南473061

出　　处：《中国临床新医学》2016年第11期1007-1009,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨子宫动脉栓塞术(uterine artery embolization,UAE)治疗难治性产后出血的疗效及意义。方法选取该院妇产科收治的难治性产后出血患者71例,根据治疗方式的不同分为观察组36例和对照组35例。观察组在常规治疗的基础上行双侧子宫动脉明胶海绵颗粒栓塞术;对照组应用常规的治疗方法,按摩子宫、缩宫药物注射、宫腔纱布填塞或者改良式B-Lynch缝合术等,上述方法无效时行子宫切除术。比较两组患者的止血效果、抢救输血量及术后并发症发生等情况。结果观察组UAE治疗后出血立即停止,有效率为100.00%,对照组中22例止血有效,有效率为62.86%,两组比较差异有统计学意义(χ2=16.368,P=0.000);两组抢救输血量分别为(1200±180)ml、(1597±182)ml,两组比较差异有统计学意义(t=9.241,P=0.000)。结论 UAE具有止血迅速、创伤小、并发症少等优点,是治疗难治性产后出血的有效方法,且节约了血源,保留了生殖功能,提高了产妇的生活质量。Objective To evaluate the clinical value of uterine artery embolization in the treatment of intractable postpartum hemorrhage. Methods Thirty-six cases with intractable postpartum hemorrhage were collected as the observation group,and the bilateral uterine artery embolization with gelatin sponge particles was performed on them on the basis of the routine treatment. Other 35 matched cases were collected as the control group and received the conventional treatment,including massage of the uterus,injection of drugs for uterine contraction and intra-uterine pack with sterilized gauze or modified B-Lynch suture. Hysterectomy was performed on those whose treatments had failed. The hemostatic effect,consumption of blood and the postoperative complications were compared between the two groups. Results The immediately stopped bleeding by arterial embolization was 100% in the observation group and 62. 86% in the control group,with a significant difference between the two groups（ χ2= 16. 368,P = 0. 000）;The consumption of blood in the observation group was significantly less than that in the control group[（ 1200 ± 180） ml vs（ 1597 ± 182） ml],（ t = 9. 241,P = 0. 000）. Conclusion Uterine artery embolization is effective in the treatment of intractable postpartum hemorrhage,with the advantages of rapid hemostasis,small trauma and less complications.

关 键 词：难治性产后出血 子宫动脉栓塞术 临床分析 

分 类 号：R719[医药卫生—妇产科学]