子宫收缩乏力性难治性产后出血患者介入治疗效果的影响因素

Influencing Factors on Effect of Interventional Therapy in Patients with Intractable Postpartum Hemorrhage Caused by Uterine Atony

目的分析子宫收缩乏力性难治性产后出血患者介入治疗效果的影响因素。方法选取2018年10月至2021年10月商丘市长征人民医院收治的200例接受介入治疗的子宫收缩乏力性难治性产后出血的患者,评估患者介入治疗效果并分组,将介入治疗成功的患者纳入成功组,将介入治疗失败的患者纳入失败组。询问两组患者基线资料并记录研究所需资料,将可能的影响因素纳入,分析子宫收缩乏力性难治性产后出血患者介入治疗效果的影响因素。结果200例子宫收缩乏力性难治性产后出血患者中,166例成功,成功率为83.00%;34例出现二次出血,失败率为17.00%。失败组年龄、体质量指数(BMI)、孕周、孕次、人工流产史、分娩方式、多胎妊娠、产后24h失血量、术中输注血浆量、住院时间、住院期间是否有发热与成功组比较,差异无统计学意义(P>0.05);失败组有妊娠合并症、有凝血功能障碍、并发弥散性血管内凝血(DIC)占比高于成功组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,合并妊娠合并症、有凝血功能障碍、并发DIC是子宫收缩乏力性难治性产后出血患者介入治疗效果的危险因素(OR>1,P<0.05)。结论合并妊娠合并症、有凝血功能障碍、并发DIC是子宫收缩乏力性难治性产后出血患者介入治疗失败的影响因素。

Objective To analyze the influencing factors on effect of interventional therapy in patients with intractable postpartum hemorrhage caused by uterine atony.Methods A total of 200 patients with intractable postpartum hemorrhage caused by uterine atony who were treated with interventional therapy in Shangqiu Changzheng People's Hospital from October 2018 to October 2021 were selected.The effect of interventional therapy was evaluated and the patients were divided into groups.Patients with successful interventional therapy were included in the success group and patients with failed interventional therapy were included in the failure group.The baseline data of the two groups of patients were asked and the data required for the study were recorded,and the possible influencing factors were included.The influencing factors on effect of interventional therapy in patients with intractable postpartum hemorhage caused by uterine atony were analyzed.Results Among the 200 patients with intractable postpartum hemorrhage caused by uterine atony,166 cases were successful,the success rate was 83.00%,and 34 cases had secondary bleeding,the failure rate was 17.00%.The age,,body mass index(BMI),gestational weeks,gestational times,history of induced abortion,mode of delivery,multiple pregnancy,blood loss at 24 hours post partum,intraoperative plasma transfusion,length of hospital stay and fever between the failure group and the success group were compared,and there was no statistical signifcant difference(P>0.05).The proportion of pregnancy complications,coagulation dysfunction and disseminated intravascular coagulation(DIC)in the failure group were higher than that in the success group(P<0.05).The results of logistic regression analysis showed that,complicat ions duri ng pregnancy,coagulation dysfunction and DIC were the risk factors for therapeutic effect of interventional therapy in patients with intractable postpartum hemorrhage caused by uterine atony(OR>1,P<0.05).Conclusion Pregnancy complications,coagulation dysfunction and DIC are the influencing factors on failure of interventional therapy in patients with refractory postpartum hemorrhage caused by uterine atony.