双侧子宫动脉结扎术联合垂体后叶素封闭技术在难治性产后出血救治中的有效性与安全性研究  

Efficacy and safety of bilateral uterine artery ligation combined with posterior pituitary hormone blocking technique in the treatment of refractory postpartum hemorrhage

作　　者：杜兰云 王芳[2] 陈书霞 樊利平[1] 王瑾 王彦欣[3] DU Lan-yun;WANG Fang;CHEN Shu-xia(Department of Obstetrics,Affiliated Hospital of Hebei University of Technology,Handan Hebei 056002,China;Department of Respiratory,Affiliated Hospital of Hebei University of Technology,Handan Hebei 056002,China)

机构地区：[1]河北工程大学附属医院产科,河北邯郸056002 [2]河北工程大学附属医院呼吸科,河北邯郸056002 [3]衡水市第五人民医院妇产科,河北衡水053000

出　　处：《临床和实验医学杂志》2025年第6期633-636,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省卫生和计划生育委员会科研项目(编号:20240994)。

摘　　要：目的研究双侧子宫动脉结扎术联合垂体后叶素封闭技术在难治性产后出血救治中的有效性与安全性。方法回顾性纳入2023年6月至2024年9月河北工程大学附属医院收治的180例难治性产后出血患者,根据治疗方法不同分为联合组、手术组和对照组,每组各60例。联合组患者采取双侧子宫动脉结扎术联合垂体后叶素封闭治疗,手术组患者采取双侧子宫动脉结扎术治疗,对照组患者采取垂体后叶素封闭治疗。对3组患者的治疗总有效率、临床症状(用药后2 h出血量、止血时间、恶露持续时间)、血液学指标[D-二聚体(D-D)、血红蛋白、纤维蛋白原(FIB)]、血清因子[一氧化氮合酶(NOS)、一氧化氮(NO)]水平及不良反应发生率进行分析和比较。结果联合治疗组的总有效率为98.33%,高于手术组(88.33%)和对照组(80.00%),差异均有统计学意义(P<0.05)。联合组用药后2 h出血量为(75.12±15.33)mL,少于手术组[(112.42±23.54)mL]和对照组[(134.54±31.22)mL],止血时间、恶露持续时间分别为(6.35±2.12)h、(9.54±1.86)d,均短于手术组[(9.77±3.25)h、(12.73±3.15)d]和对照组[(13.21±4.55)h、(14.81±4.25)d],差异均有统计学意义(P<0.05)。治疗后,联合组的D-D、FIB水平分别为(1.21±0.45)mg/L、(2.12±0.15)g/L,均低于手术组[(1.96±0.33)mg/L、(2.92±0.41)g/L]和对照组[(2.12±0.34)mg/L、(3.15±0.17)g/L],血红蛋白为(13.64±2.13)g/dL,均高于手术组[(11.31±2.26)g/dL]和对照组[(10.51±3.12)g/dL],差异均有统计学意义(P<0.05)。治疗后,联合组的NOS、NO分别为(11.12±2.18)、(24.62±3.23)μmol/L,均高于手术组[(9.98±2.32)、(18.49±2.22)μmol/L]和对照组[(8.23±2.13)、(11.32±2.51)μmol/L],差异均有统计学意义(P<0.05)。联合组总不良反应发生率为23.33%,低于手术组(61.67%)和对照组(80.00%),差异均有统计学意义(P<0.05)。结论双侧子宫动脉结扎术联合垂体后叶素封闭技术在难治性产后出血救治中具有良好的�Objective To evaluate the efficacy and safety of bilateral uterine artery ligation combined with posterior pituitary hormone blocking technique for refractory postpartum hemorrhage.Methods A total of 180 patients with refractory postpartum hemorrhage admitted to the Affiliated Hospital of Hebei University of Technology from June 2023 to September 2024 were retrospectively included.According to the different treatment methods,they were divided into the combined group,the operation group and the control group,with 60 cases in each group.Patients in the combined group were treated with bilateral uterine artery ligation combined with posterior pituitary hormone blocking technique,patients in the operation group were treated with bilateral uterine artery ligation,and patients in the control group were treated with posterior pituitary hormone blocking technique.The total effective rate,clinical symptoms(amount of bleeding at 2 h after treatment,hemostasis time and lochia duration),hematological indicators[D-dimer(D-D),hemoglobin,fibrinogen(FIB)],serum factor[nitric oxide synthase(NOS),nitric oxide(NO)]levels,and incidence of adverse reactions were analyzed and compared among the three groups.Results The total effective rate of the combined treatment group was 98.33%,which was higher than that of the operation group(88.33%)and the control group(80.00%),and the differences were statistically significant(P<0.05).The amount of bleeding at 2 h after treatment in the combined group was(75.12±15.33)mL,which was less than that in the operation group[(112.42±23.54)mL]and the control group[(134.54±31.22)mL],the hemostasis time and lochia duration were(6.35±2.12)h and(9.54±1.86)d,respectively,which were shorter than those in the operation group[(9.77±3.25)h and(12.73±3.15)d]and the control group[(13.21±4.55)h and(14.81±4.25)d],and the differences were statistically significant(P<0.05).After treatment,the levels of D-D and FIB in the combined group were(1.21±0.45)mg/L and(2.12±0.15)g/L,respectively,which were lower than

关 键 词：难治性产后出血 子宫动脉结扎术 垂体后叶素 联合治疗 

分 类 号：R714.46[医药卫生—妇产科学]