血管结扎与栓塞术治疗剖宫产术后子宫收缩乏力性产后出血疗效  

Effect of vasectomy and embolization for treating postpartum hemorrhage because of uterine asthenia of women after cesarean section

作　　者：单媛媛[1] 黎渊明 SHAN Yuanyuan;LI Yuanming(The Fourth People's Hospital of Kunshan,Jiangsu Province,215331;The First People's Hospital of Kunshan)

机构地区：[1]江苏省昆山市第四人民医院,215331 [2]江苏省昆山市第一人民医院

出　　处：《中国计划生育学杂志》2020年第2期268-271,共4页Chinese Journal of Family Planning

摘　　要：目的:分析子宫动脉结扎术与子宫动脉栓塞术对剖宫产术后子宫收缩乏力性产后出血的止血效果及影响因素。方法:回顾性分析2015年1月—2019年3月本院剖宫产分娩发生产后出血且行子宫动脉结扎(34例)或子宫动脉栓塞术(40例)患者临床资料,另选年龄匹配的非孕期正常查体女性为对照组,比较两种止血效果及失败的可能因素。结果:子宫动脉结扎与栓塞止血成功率无差异(P>0.05),子宫动脉结扎组术前出血量小于子宫动脉栓塞组,手术时间大于子宫动脉栓塞组(P<0.05);术后双侧子宫动脉血流RI子宫动脉结扎及栓塞组均大于对照组(P<0.05),而结扎组与栓塞组无差异(P>0.05),3组双侧子宫动脉血流S/D无差异(P>0.05);止血失败组年龄、急症剖宫产、瘢痕子宫、凝血功能异常比例均高于止血成功组(P<0.05),分娩孕周及产次≥2次比例两组无差异(P>0.05),急症剖宫产、瘢痕子宫、凝血功能异常是止血失败的独立危险因素(P<0.05),年龄≥35岁与止血失败无相关性(P>0.05)。结论:子宫动脉结扎术或栓塞术的止血成功率及对产妇远期子宫动脉血流参数的影响相当,急症剖宫产、瘢痕子宫、凝血功能异常会影响两种手术止血效果。Objective:To analyze the effect of vasectomy and embolization for treating postpartum hemorrhage because of uterine asthenia of women after cesarean section,and to study its influencing factors.Methods:The clinical data of 34 women with uterine artery ligation(in group A)and 40 women with uterine artery embolization(in group B)because of postpartum hemorrhage during cesarean section were analyzed retrospectively.Other normal women were included in group C.The efficacy of the two hemostasis methods was compared,and the influencing factors of hemostasis failure were analyzed.Results:There was no statistically significant different in the hemostasis success rate of women between the two groups(P>0.05).The amount of preoperative blood loss of women in group A was significant less than that of women in group B,but the operation time of women in group A was significant longer(P<0.05).Bilateral uterine artery blood flow RI by ultrasound of women in group A and B was significant more than that of women in group C(P<0.05),but that of women had no significant difference between group A and B(P>0.05).There was no significant different in bilateral uterine artery blood flow S/D of women among the three groups(P>0.05).The age,the rate of emergency cesarean section,scar uterus history,and abnormal coagulation function of women with failed hemostasis were significantly higher than those of women with successful hemostasis(P<0.05).There was no significant different in gestional weeks when delivery and the proportion of parity≥2 times of women between group A and B(P>0.05).The emergency cesarean section,scar uterus history,and abnormal coagulation function were independent risk factors for hemostasis failure(P<0.05),but age≥35 years old was no correlated with hemostatic failure(P>0.05).Conclusion:The success rate of uterine artery ligation used for the hemostasis and its influence on the long-term uterine artery blood flow parameters of pregnant women are similar to those of uterine artery embolization.And emergency cesarean

关 键 词：产后出血 子宫收缩乏力 子宫动脉结扎 子宫动脉栓塞 

分 类 号：R719.8[医药卫生—妇产科学]