两种不同方法治疗产后出血所致不同程度休克的临床疗效对比及DSA影像特点

发布时间：2018-07-01 19:26

本文选题：介入治疗 + 产科治疗　；参考：《中国妇产科临床杂志》2017年03期

【摘要】：目的探究对比产科治疗与介入治疗对产后出血所致不同程度休克的临床疗效及DSA影像特点。方法选取苏州市第七人民医院2012年12月至2015年12月期间收治的、符合纳入标准的产后出血患者150例,随机分为对照组(n=75)和介入组(n=75);两组在治疗前0.5~1.0 h内,根据休克病程分为轻度、中度、重度休克,来观察补液量、补血量、休克纠正时间、康复时间和子宫保有率等情况;并观察两组不同程度休克的DSA影像学特点。结果 (1)轻度休克:介入组缩短了休克纠正时间(t=8.689,P0.001)、康复时间(t=9.709,P0.001),但补液量、补血量、子宫保有率差异均无统计学意义(P0.05)。DSA影像可见子宫染色较深;(2)中度休克:介入组缩短了休克纠正时间(t=17.351,P0.001)和康复时间(t=11.831,P0.001),减少了补液量(t=15.611,P0.001)和补血量(t=7.782,P0.001),但子宫保有率差异无统计学意义(χ~2=0.001,P=0.972)。DSA可见子宫出现小点或片状影,有对比剂外渗现象;(3)重度休克:介入组对于补液量、补血量、休克纠正时间和康复时间差异均有统计学意义(t=5.946、7.665、23.546、4.680,P0.001),但子宫保有率无统计学意义(χ~2=1.991,P=0.158)。DSA可见大片状影,有外渗、集聚现象。结论介入治疗对于休克程度越重的产后出血具有较好疗效,临床上可供参考。
[Abstract]:Objective to investigate the clinical effects and DSA imaging features of obstetric therapy and interventional therapy in the treatment of postpartum hemorrhage with different degrees of shock. Methods 150 postpartum hemorrhage patients admitted from December 2012 to December 2015 in Suzhou Seventh people's Hospital were randomly divided into two groups: control group (n = 75) and interventional group (n = 75). According to the course of shock were divided into mild moderate and severe shock to observe the fluid volume blood volume shock correction time recovery time and uterine retention rate and observe the DSA imaging characteristics of different degrees of shock in the two groups. Results (1) mild shock: in the intervention group, the shock correction time was shortened (t = 8.689), the recovery time was (t = 9.709) P 0.001, but the volume of fluid infusion and blood supply were increased. There was no significant difference in uterine retention rate (P0.05) .DSA images showed deep uterine staining; (2) moderate shock: in the intervention group, shock correction time (tn 17.351g / P0.001) and recovery time (tn 11.831g / P0.001) were shortened, fluid resuscitation and blood volume were decreased (tn = 15.611g / 0.001) and blood supply (t = 7.782n / P0.001), but the difference of uterine retention rate was found in the interventional group (tn = 17.351g / kg) and recovery time (t = 11.831g / P0.001), respectively. There was no statistically significant difference (蠂 ~ 2 ~ (2) 0. 001P ~ (1) P ~ (0. 972) .DSA showed that there were small spots or flaky shadows in the uterus. (3) severe shock: in the intervention group, there were significant differences in fluid volume, blood volume, shock correction time and recovery time (t = 5.9467.6653.5464.680p 0.001), but there was no significant difference in uterine retention rate (蠂 ~ 21.991P0.158). Conclusion Interventional therapy is effective for postpartum hemorrhage with severe shock.
【作者单位】：苏州市第七人民医院妇产科;苏州大学附属第二医院介入科;
【分类号】：R714.46

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