超选择性子宫动脉栓塞术在产科大出血治疗中的价值

发布时间：2018-05-17 01:09

本文选题：产后出血 + 动脉　；参考：《重庆医学》2015年22期

【摘要】：目的探讨超选择性子宫动脉栓塞术在产科大出血治疗中的技术操作成功率、安全性、疗效及临床价值。方法回顾性分析经内科方法治疗无效的产后大出血者临床资料65例,其中,行超选择子宫动脉栓塞术止血成功41例作为A组,行子宫切除术治疗24例作为B组,分析比较两组止血成功率、出血量和术后并发症。结果 A组因病情异常危重而不能耐受子宫切除者为26.8%(11/41),止血成功率95.1%(39/41),栓塞后因止血效果不佳再行子宫切除者4.9%(2/41);B组止血成功率95.8%(23/24),两组比较差异无统计学意义(P0.05)。A、B平均手术时间分别为33.8min、61.5min,两组差异有统计学意义(P0.01);A、B组平均出血量分别为2 155.5mL、3 215.7mL,差异具有统计学意义(P0.01);A组无并发症、B组出现并发症3例,差异具有统计学意义(P0.01)。结论超选择子宫动脉栓塞术具有适应证广、微创、止血成功率高、并发症少及保全子宫等优势。
[Abstract]:Objective to investigate the success rate, safety, efficacy and clinical value of superselective uterine artery embolization in the treatment of obstetric massive hemorrhage. Methods the clinical data of 65 patients with massive postpartum hemorrhage who had been treated with medical treatment were retrospectively analyzed. Among them, 41 cases were treated with hysteroselective uterine artery embolization as group A, and 24 cases were treated with hysterectomy as group B. The hemostatic success rate, bleeding volume and postoperative complications were analyzed and compared between the two groups. Results in group A, the rate of hysterectomy was 26.810 / 41, and the success rate of hemostasis was 95.1- 39 / 41g. After embolization, the successful rate of hemostatic hysterectomy was 4.910 / 41g / 41g / 2 / 41g / B, and the average hemostatic success rate of group B was 95.8% / 24%. There was no significant difference between the two groups in the average hemostatic success rate (P 0.05). The operative time was 33.8 min and 61.5 min, respectively. The average blood loss in group B was 2155.5 mL / L and 3215.7mL, respectively. There were 3 cases of complications in group B without complications in group A (P 0.01), and there were 3 cases of complications in group B (P < 0.05). The difference was statistically significant (P 0.01). Conclusion Over-selective uterine artery embolization has advantages of wide indication, minimally invasive, high success rate of hemostasis, less complications and uterine preservation.
【作者单位】：重庆市垫江县中医院放射科;重庆市垫江县人民医院介入室;
【分类号】：R714.461

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