子宫动脉栓塞术与传统外科止血治疗难治性产后出血的临床效果及安全性  

Clinical effect and safety of uterine artery embolization and traditional surgical hemostasis in the treatment of refractory postpartum hemorrhage

作　　者：李晓燕 LI Xiaoyan(Department of Obstetrics and Gynecology,Xiangyang Hospital of Traditional Chinese Medicine Xiangyang National Rescarth Institute of Chinese Medicine,Xiangyang 441000,China)

机构地区：[1]湖北省襄阳市中医医院(襄阳市中医药研究所)妇产科,湖北襄阳441000

出　　处：《中国现代医生》2021年第13期76-78,83,共4页China Modern Doctor

摘　　要：目的分析子宫动脉栓塞术与传统外科止血治疗难治性产后出血的临床效果及安全性。方法筛选的70例难治性产后出血病例,为2018年3月至2020年2月于本院分娩患者。以随机数字表法分组,每组各35例。对照组以传统外科止血治疗,包括宫腔填塞纱布、球囊压迫止血等;观察组采用子宫动脉栓塞术治疗,比较两种治疗方案的止血效果及安全性。结果观察组止血成功率明显高于对照组,子宫切除率低于对照组(P<0.05);观察组止血时间早于对照组,输血量明显少于对照组(P<0.05)。观察组患者治疗并发症发生率2.9%,对照组为11.1%,观察组明显低于对照组(P<0.05)。观察组患者下床活动时间早于对照组,住院时间短于对照组,生活质量评分高于对照组(P<0.05)。结论与传统外科止血治疗相比,子宫动脉栓塞术治疗难治性产后出血止血效果更好,止血时间明显缩短,可有效减少对患者机体的损伤,且并发症少,避免了切除子宫的不良后果,临床效果和安全性有保证,应用价值高。Objective To analyze the clinical effect and safety of uterine artery embolization and traditional surgical hemostasis in the treatment of refractory postpartum hemorrhage.Methods A total of 70 cases of refractory postpartum hemorrhage screened were delivered in our hospital from March 2018 to February 2020.They were divided into two groups by random number table method,with 35 cases in each group.The control group was treated with traditional surgical hemostasis,including intrauterine packing with gauze,balloon compression hemostasis,etc.The observation group was treated with uterine artery embolization.The hemostatic effect and safety of the two treatment schemes were compared.Results Compared with the control group,the success rate of hemostasis was higher and the hysterectomy rate was lower in the observation group(P<0.05).The hemostasis time was earlier in the observation group than that in the control group,and the blood transfusion volume was less than that in the control group(P<0.05).The incidence rate of treatment complications was 2.9%in the observation group,while that in the control group was 11.1%,which was even lower in the observation group(P<0.05).The time of getting out of bed was earlier in the observation group that that in the control group,the hospitalization time was shorter in the observation group than that in the control group,and the score of the quality of life was higher in the observation group than that in the control group(P<0.05).Conclusion Compared with traditional surgical hemostasis,uterine artery embolization has a better hemostasis effect,shorter hemostasis time,less damage to patients′body,and fewer treatment complications,which can avoid adverse consequences of hysterectomy,and guarantee clinical effect and safety,with higher application value.

关 键 词：难治性产后出血 子宫动脉栓塞术 宫腔填塞纱布 球囊压迫止血 子宫切除术 止血效果 安全性 

分 类 号：R714.46[医药卫生—妇产科学]