动脉栓塞联合宫颈钳夹术治疗难治性产后出血的临床分析

发布时间：2018-04-19 14:20

本文选题：宫颈钳夹术 + 动脉栓塞术　；参考：《实用妇产科杂志》2015年09期

【摘要】：目的:探讨降低难治性产后出血患者行动脉栓塞术前在转运途中发生大出血及降低术中大出血风险的方法。方法:选择2010年1月至2012年1月41例难治性产后出血拟行动脉栓塞术治疗的患者为对照组,2012年2月至2014年5月43例难治性产后出血在拟行动脉栓塞术前先行宫颈钳夹术治疗的患者为研究组,研究组患者均先行宫颈钳夹术,再转运至介入室予动脉栓塞术治疗。比较两组治疗的效果、术中出血量和并发症情况。结果:对照组仅38例完成动脉栓塞术,3例送介入室途中大量出血致失血性休克改行子宫切除;研究组43例患者均完成动脉栓塞术联合宫颈钳夹术。对照组行动脉栓塞术术中出血量(436±354 ml)高于研究组(125±113 ml),对照组术中失血性休克发生率(15.8%,6/38)高于研究组(0),对照组子宫切除率12.2%(5/41)高于研究组(0),对照组治疗有效率87.8%(36/41)低于研究组(100.0%,43/43),以上比较,差异均有统计学意义(P0.05)。结论:难治性产后出血患者在行动脉栓塞术前行宫颈钳夹术,可以降低其在术前转运途中发生大出血的风险,动脉栓塞联合宫颈钳夹术能有效减少失血性休克的发生、降低子宫切除率、提高动脉栓塞术成功率。
[Abstract]:Objective: to investigate the methods of reducing the risk of massive hemorrhage and intraoperative hemorrhage in patients with refractory postpartum hemorrhage before arterial embolization.Methods: from January 2010 to January 2012, 41 patients with refractory postpartum hemorrhage were selected as control group. 43 patients with intractable postpartum hemorrhage from February 2012 to May 2014 were selected as control group.The patients treated with pliers were the study group.All the patients in the study group were treated with cervical forceps, and then transferred to interventional chamber for arterial embolization.Results, intraoperative bleeding and complications were compared between the two groups.Results: in the control group, only 38 patients underwent arterial embolization and 3 patients underwent hysterectomy due to massive hemorrhage on the way to the interventional chamber, while 43 patients in the study group underwent arterial embolization combined with cervical clamp.The blood loss during arterial embolization was 436 卤354 ml in the control group, 125 卤113 ml in the study group. The incidence of hemorrhagic shock in the control group was 15.880 / 38), and the hysterectomy rate in the control group was 12.2g / 41.It was significantly higher than that in the study group. The effective rate of treatment in the control group was 87.8% 36 / 41) lower than that in the control group.The research group 100.010% 43% 43%, the above comparison,The difference was statistically significant (P 0.05).Conclusion: cervical clamp before arterial embolization can reduce the risk of massive bleeding in patients with intractable postpartum hemorrhage. Arterial embolization combined with cervical clamp can effectively reduce the occurrence of hemorrhagic shock.Reduce the rate of hysterectomy and improve the success rate of arterial embolization.
【作者单位】：江西省妇幼保健院;南昌大学第一附属医院;
【分类号】：R714.461

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