双侧髂内动脉栓塞术和结扎术对产后大出血的临床疗效比较

Comparison of Curative Effect on Postpartum Hemorrhage between Bilateral Internaliliac Artery Embolization and Internal Iliac Artery Ligation

目的比较双侧髂内动脉栓塞和髂内动脉结扎对产后出血的止血效果及术后并发症.方法产后大出血患者40例,20例行双侧髂内动脉栓塞,20例行双侧髂内动脉结扎,术后观察止血效果和术后并发症.结果2组患者止血有效率均为100%.髂内动脉栓塞组:13例患者栓塞后即刻止血,7例栓塞后出血明显减少,对症治疗2～5 d后停止出血;术后下腹疼痛3例,发热2例,恶心、呕吐5例,1周后所有术后并发症均缓解.髂内动脉结扎组:8例患者栓塞后即刻止血,12例栓塞后出血明显减少,对症治疗2～5 d后停止出血;术后下腹疼痛11例,发热10例,恶心、呕吐13例,1周后所有术后并发症均缓解.髂内动脉结扎术后并发症发生率高于髂内动脉栓塞术(P<0.05).结论双侧髂内动脉栓塞和髂内动脉结扎都是妇产科大出血的有效治疗手段,但是髂内脉栓塞术后并发症发生率较低.

Objective To compare the curative effect and adverse reaction of bilateral internal iliac artery embolization with internal iliac artery ligation in postpartum hemorrhage. Methods 40 cases with postpartum hemorrhage were divided into two groups： experimental group and control group underwent bilateral internaliliac artery embolization and internal iliac artery ligation respectively, with 20 cases in each group .The curative effect and adverse reactions were observed and compared. Results The effective rates of both groups were 100%. In the experimental group, 13 cases of hemorrhage stopped immediately after embolization, and 7 cases of hemorrhage significantly reduced after embolization and the hemorrhage stopped after symptomatic treatment for 2-5 days. There were abdomen and hip pain in 3 patients, fever in 2 cases and nausea and vomiting in 5 cases, and all adverse reactions were alleviated after 1 week. In the control group, 8 cases of hemorrhage stopped immediately after embolization, and 12 cases of hemorrhage significantly reduced after embolization and the hemorrhage stopped after symptomatic treatment for 2-5 days. There were abdomen and hip pain in 11 patients, fever in 10 cases and nausea and vomiting in 13 cases, and all adverse reactions were alleviated after 1 week. The incidence of postoperative complications in the control group was higher than that in experimental group （P 〈 0.05）. Conclusion The bilateral internal iliae artery embolization and internal iliac artery ligatiou were the effective means for treating gynecological massive hemorrhage, but the internal itiac artery embolization is better with lower incidence of adverse reactions.