子宫动脉栓塞术治疗难治性产后大出血的效果及安全性研究  

The efficacy and safety of uterine artery embolization in the treatment of intractable gynaecological haemorrhage

作　　者：郭琛[1] 包秀芳[1] 孙萍[1] Guo Chen;Bao Xiufang;Sun Ping(Department of Obstetric, Nei Affiliated Hospital of Inner Mongolia University for Nationalities, Tongliao 028000, Inner Mongolia, China)

机构地区：[1]内蒙古民族大学附属医院产科,内蒙古通辽028000

出　　处：《血管与腔内血管外科杂志》2018年第5期428-432,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨子宫动脉栓塞术治疗难治性产后大出血患者的临床效果及安全性。方法选取2017年1月至2018年9月期间内蒙古民族大学附属医院收治的94例难治性妇产科大出血患者作为研究对象,采用随机数字表法将其分为参照组和研究组,每组各47例患者。经缩宫药物注射、宫腔纱布填塞等常规治疗无效后,参照组患者行子宫切除术治疗,研究组患者则采用子宫动脉栓塞术治疗。观察2组患者大出血的临床治疗效果,手术时间和术中出血量以及输血量等指标,并统计分析2组患者不良反应的发生情况。结果研究组患者止血的总有效率为95.74%,参照组的总有效率为100.00%,比较差异无统计学意义(P<0.05)。研究组手术治疗时间短于参照组,研究组术中出血量和输血量也明显少于参照组,差异均具有统计学意义(P<0.05)。研究组术后并发症发生率为12.76%,低于参照组的29.79%,差异具有统计学意义(P<0.05)。结论应用子宫动脉栓塞术治疗难治性产后大出血的临床效果良好,具有手术时间短、止血效果好、创伤小且并发症少的特点,值得在临床上进行推广应用。Objective To investigate the clinical effect and safety of uterine artery embolization in the treatment of refractory postpartum hemorrhage. Methods From January 2017 to September 2018, a total of 94 patients with refractory postpartum hemorrhage were selected from affiliated Hospital of Inner Mongolia University for nationalities as the objects of study. They were divided into reference group and research group by random digital table method, with 47 patients in each group. The patients in the reference group were treated with hysterectomy and the patients in the research group were treated with uterine artery embolization after the routine treatment such as drug injection and gauze packing were not effective. The clinical treatment effect, operative time, intraoperative bleeding volume and blood transfusion volume of patients with massive hemorrhage in both groups were observed. The incidence of adverse reactions in the two groups was analyzed statistically. Results The total effective rate of hemostasis in the trial group was 95.74%, which was not significantly different from that in the reference group(100.00%)(P<0.05). The operative time of the patients in the trial group was shorter than that in the control group, and the amount of intraoperative blood loss and blood transfusion in the trial group was significantly lower than that in the control group(P<0.05). The incidence of postoperative complications in the trial group was 12.76%, which was significantly lower than that in the control group(29.79%)(P<0.05). Conclusion Uterine artery embolization is effective in the treatment of refractory postpartum hemorrhage. It has the characteristics of short operation time, good hemostatic effect, less trauma and less complications, so it is worth popularizing and applying in clinic.

关 键 词：难治性 产后大出血 子宫动脉栓塞 治疗效果 安全性 

分 类 号：R543.1[医药卫生—心血管疾病]