数字减影血管造影辅助下盆腔动脉栓塞治疗难治性产后出血临床观察  

Observation on treating intractable postpartum hemorrhage using digital subtraction angiography assisted pelvic artery embolization

作　　者：戴英苗 张文浩 DAI Ying-miao(Department of Obstetrics and Gynecology,the people's hospital of Yangjiang City,Yangjiang,Guangdong,529500,China)

机构地区：[1]阳江市人民医院妇产科,广东阳江529500

出　　处：《齐齐哈尔医学院学报》2020年第20期2526-2529,共4页Journal of Qiqihar Medical University

摘　　要：目的探讨数字减影血管造影(DSA)技术辅助下盆腔动脉栓塞治疗难治性产后出血的临床效果,为临床治疗提供参考。方法回顾性分析2017年1月—2020年5月本院收治的120例难治性产后出血患者的临床资料,按止血方式不同将患者分为观察组和对照组两组,每组各60例。对照组使用子宫压迫缝合术治疗,观察组使用DSA辅助下盆腔动脉栓塞术治疗,比较两组止血效果、围术期情况、输血情况、手术前及手术后48 h后血红蛋白(Hb)水平变化及术后并发症。结果治疗后,观察组止血成功率为96.7%,明显高于对照组的85.0%,差异有统计学意义(P<0.05);观察组手术时间、术中止血时间、下床活动时间及住院时间分别为(43.73±5.95)min、(7.05±1.85)min、(3.12±0.53)d、(7.95±1.03)d,均短于对照组的(55.81±4.08)min、(12.33±2.01)min、(4.31±1.42)d、(11.32±1.50)d,差异均有统计学意义(均P<0.05);观察组术中出血量、血浆输注量、红细胞输注量分别为(211.83±31.45)ml、(1375.21±276.04)mL、(5.10±0.56)U,均少于对照组的(320.19±27.83)ml、(1903.35±251.48)ml、(7.93±0.81)U,差异均有统计学意义(均P<0.05);观察组术后Hb水平为(105.53±4.84)g/L,高于对照组的(99.01±5.32)g/L,差异有统计学意义(P<0.05);两组术后感染、腹部疼痛、发热等并发症总发生率比较,差异无统计学意义(P>0.05)。结论DSA辅助下盆腔动脉栓塞术治疗难治性产后出血效果明显,可明显提高止血成功率,促进术后恢复,安全性好,值得应用推广。Objective To study the clinical effect of digital subtraction angiography(DSA) assisted pelvic artery embolization in treating intractable postpartum hemorrhage, in order to provide reference for clinical treatment.Methods The clinical data of 120 patients with intractable postpartum hemorrhage those admitted to Yangjiang people’s hospitalfrom January 2017 to May 2020 were retrospectively analyzed,they were divided into the observation groupand the control group according to the different hemostasis methods they received, 60 cases in each group.The control group was treated with uterine compression suture for treatment, and the observation group was treated with DSA assisted pelvic artery embolization. The hemostatic efficacy, perioperative conditions, blood transfusion, the changes of hemoglobin(Hb) levels before operation and 48 hours after operation and postoperative complications were compared between the two groups. Results After treatment, the success rate ofhemostasis in the observation group was 96.7%, which was significantly higher than 85.0% of the control group, with statistically significant(P<0.05).The operation time, intraoperative hemostasis time, time period from the completion of operation to get off bed for exercise and hospitalization time of the observation group were(43.73±5.95)min,(7.05±1.85)min,(3.12±0.53)d,(7.95±1.03)d, which was significantly shorter than that [(55.81±4.08)min,(12.33±2.01)min,(4.31±1.42)d,(11.32±1.50)d] of the control group, the differences were statistically significant(P<0.05). The intraoperative blood loss, plasma transfusion and red blood cell transfusion were(211.83±31.45)mL,(1375.21±276.04)mL,(5.10±0.56)U,which was significantly less than(320.19±27.83)mL,(1903.35±251.48)mL, and(7.93±0.81)Uof the control group, with statistically significant(P<0.05). The Hb level in the observation group was(105.53±4.84)g/L, which was significantly higher than that of the control group(99.01±5.32)g/L, with statistically significant(P<0.05). The total incidence of po

关 键 词：数字减影血管造影 难治性产后出血 盆腔动脉栓塞术 子宫压迫缝合术 止血效果 

分 类 号：R714.4[医药卫生—妇产科学]