自然分娩产妇低强度聚焦超声子宫复旧治疗防治产后出血的前瞻性随机对照研究  

A prospective randomized controlled study of low intensity focused ultrasound uterine involution treatment for prevention and treatment of postpartum hemorrhage in natural childbirth women

作　　者：李小飞 刘洪莉[1] 石丘玲 田静 李莉[4] 漆洪波[1] 罗欣[1] Xiaofei Li;Hongli Liu;Qiuling Shi;Jing Tian;Li Li;Hongbo Qi;Xin Luo(Department of Obstetrics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;State Key Laboratory of Ultrasound in Medical and Engineering,Chongqing Medical University,Chongqing 400016,China;Department of Obstetrics,the University-Town Hospital of Chongqing Medical University,Chongqing 401331,China;Department of Obstetrics,Chongqing Health Center for Women and Children,Chongqing 401147,China)

机构地区：[1]重庆医科大学附属第一医院产科,重庆400016 [2]重庆医科大学超声医学工程国家重点实验室,重庆400016 [3]重庆医科大学附属大学城医院产科,重庆401331 [4]重庆市妇幼保健院产科,重庆401147

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第5期534-539,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(82171688);超声医学工程国家重点实验室开放课题项目(2021KFKT013)。

摘　　要：目的探讨低强度聚焦超声(LIFU)子宫复旧治疗,对防治自然分娩产妇产后出血(PPH)及促进子宫复旧的临床效果。方法选择2023年1月至12月于重庆市3家医院进行自然分娩的405例产妇为研究对象。采用随机数字表法,将其分为治疗组(n=202)及对照组(n=203),治疗组于产后2 h开始进行10 d LIFU子宫复旧治疗,对照组治疗方法与治疗组类似,但是在治疗时,不开启治疗仪进行能量输出。采用独立样本t检验及χ^(2)检验,对2组产妇一般临床资料,治疗前、后宫底高度及宫底下降率,治疗前、后子宫三维径线差指数,阴道出血量及恶露持续时间,以及产后并发症发生率等进行统计学比较。本研究经重庆医科大学附属第一医院人体试验伦理委员会批准(审批文号:科研伦理2021-664)。所有研究对象签署临床研究知情同意书。结果①LIFU治疗完成后,治疗组产妇宫底高度为(12.5±4.9)cm,低于对照组的(14.6±4.7)cm;宫底下降率为(41.4±5.7)%,高于对照组的(31.2±4.7)%,并且差异均有统计学意义(t=4.22、-19.48,均为P<0.001)。②LIFU治疗后,治疗组产妇子宫长径、横径及前后径长度均短于对照组,治疗前、后三径差指数均高于对照组,并且差异均有统计学意义(均为P<0.001)。③治疗组产妇产后24 h阴道出血量,血性及浆液性恶露持续时间,以及PPH率、晚期PPH率及产褥感染率,均少于、短于或低于对照组,并且差异均有统计学意义(P<0.05)。结论LIFU可有效防治PPH和促进子宫复旧。延长LIFU治疗时间(10 d疗程)还可降低产妇的晚期PPH和产褥感染风险。Objective To investigate the clinical effects of low intensity focused ultrasound(LIFU)on the prevention and treatment of postpartum hemorrhage(PPH)and the promotion of uterine involution in natural childbirth women.Methods A total of 405 women who underwent natural delivery in three hospitals in Chongqing from January to December 2023 were recruited as the study subjects.Using random number table method,405 women were randomly divided into treatment group(n=202)and control group(n=203).The treatment group received 10 days treatment of LIFU for uterine involution starting 2 h after delivery.The control group received the same procedures without energy output of therapeutic equipment.The independent-samples t test and chi-square test were used to statistically analyze the general clinical information,the fundal height and fundal descent rate before and after treatment,the three-dimensional diameter difference index of the uterus before and after treatment,the amount of vaginal bleeding,the duration of lochia,and the incidence of postpartum complications between two groups.This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University(Approval No.2021-664).Informed consent forms were obtained from all subjects.Results①After LIFU treatment,the fundal height of treatment group was(12.5±4.9)cm,which was lower than that of(14.6±4.7)cm of control group;while the fundal descent rate of treatment group was(41.4±5.7)%,which was higher than that of(31.2±4.7)%of control group,and the differences were statistically significant(t=4.22,-19.48,all with P<0.001).②After LIFU treatment,the longitudinal,anteroposterior and transverse uterine diameters in treatment group were shorter than control group,and the three-dimensional diameter difference index of the uterus before and after treatment was higher than that in control group,and the differences were statistically significant(all with P<0.001).③The amount of postpartum bleeding within 24 h after delivery,the duration of

关 键 词：产后出血 自然分娩 低强度聚焦超声 子宫复旧 产褥期感染 孕产妇 

分 类 号：R714.461[医药卫生—妇产科学]