选择性子宫动脉栓塞应用于产后大出血抢救性治疗的效果评价

Curative effect of selective uterine artery embolization in the rescue treatment of postpartum hemorrhage

目的探讨选择性子宫动脉栓塞应用于产后大出血抢救性治疗的效果。方法抽取2014年1月至2020年12月在河南省人民医院治疗的228例产后大出血患者,根据自愿原则将患者分为传统组(96例)和栓塞组(132例)。传统组采取常规止血方法,栓塞组采用选择性动脉栓塞术治疗子宫出血。观察比较两组的止血成功率、产后出血量、子宫保留率及术后并发症发生率。结果栓塞组止血成功率(97.7%,129/132)高于传统组(76.0%,73/96),P<0.05。产后2、24 h,栓塞组出血量为(98±12)、(112±15)ml,均少于对照组的(224±25)、(306±29)ml(P均<0.05)。栓塞组子宫保留率(97.7%,129/132)高于传统组(76.0%,73/96),P<0.05。两组术后并发症发生率比较差异未见统计学意义(P>0.05)。结论选择性子宫动脉栓塞术治疗难治性子宫出血的止血成功率高,适用于有生育要求的女性。

Objective To investigate the effect of selective uterine artery embolization in the rescue treatment of postpartum hemorrhage.Methods A total of 228 patients with postpartum hemorrhage treated in Henan Provincial People’s Hospital from January 2014 to December 2020 were selected and divided into traditional group(96 cases)and embolization group(132 cases)according to the principle of voluntariness.Conventional hemostasis was used in the traditional group,and selective arterial embolization was used in the embolization group to treat uterine hemorrhage.The hemostasis success rate,postpartum hemorrhage,uterine retention rate,and incidence of postoperative complications were observed and compared between the two groups.Results The success rate of hemostasis in the embolization group was 97.7%(129/132),which was higher than 76.0%(73/96)in the traditional group(P<0.05).Two and 24 hours after delivery,the amount of hemorrhage in the embolization group were(98±12)and(112±15)ml,respectively,which were lower than the(224±25)and(306±29)ml in the traditional group(all P<0.05).The uterine retention rate in the embolization group(97.7%,129/132)was higher than that in the traditional group(76.0%,73/96),P<0.05.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions Selective uterine artery embolization has a high success rate of hemostasis in the treatment of refractory uterine hemorrhage,and it is suitable for women with fertility requirements.