剖宫产难治性产后出血患者UAE术止血效果的影响因素

Influencing factors of hemostatic effect of UAE in patients with refractory postpartum hemorrhage undergoing cesarean section

目的 分析80例剖宫产难治性产后出血患者子宫动脉栓塞术(UAE)止血效果的影响因素。方法 选取鄢陵县人民医院2018年8月至2022年8月收治的80例剖宫产难治性产后出血患者作为研究对象,患者均接受UAE术治疗,根据手术止血效果将患者分为成功组和失败组。收集两组患者的临床资料,采用Logistic单因素和多因素回归分析影响UAE术止血效果的影响因素。结果 80例接受UAE治疗的剖宫产难治性产后出血患者中,70例止血成功,纳入成功组;10例止血失败者纳入失败组。单因素分析显示,产妇年龄、产次、妊娠期高血压疾病、妊娠期糖尿病、完全性前置胎盘伴胎盘植入、瘢痕子宫、凝血功能障碍、宫缩乏力均为剖宫产难治性产后出血患者UAE术止血失败的相关因素,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,产妇年龄> 35岁、妊娠期高血压疾病、妊娠期糖尿病、完全性前置胎盘伴胎盘植入、瘢痕子宫、凝血功能障碍均为剖宫产难治性产后出血患者UAE术止血失败的独立危险因素,差异有统计学意义(P<0.05)。结论 剖宫产难治性产后出血患者行UAE治疗,止血成功率受诸多因素的影响,产妇年龄> 35岁、妊娠期高血压疾病、妊娠期糖尿病、完全性前置胎盘伴胎盘植入、瘢痕子宫、凝血功能障碍均可能增加UAE止血失败的风险,临床应针对这些危险因素制定预防措施,以改善预后。

Objective To analyze the factors influencing the hemostatic effect of uterine artery embolization(UAE)in 80 patients with refractory postpartum hemorrhage during cesarean section.Methods A total of 80 patients with refractory postpartum hemorrhage during cesarean section treated in Yanling County People's Hospital from August 2018 to August 2022 were selected as subjects.All patients received UAE and were divided into the successful group and failed group according to the hemostatic effect.The clinical data of the two groups of patients were collected and Logistic univariate and multivariate regression were used to analyze the factors influencing the hemostatic effect of UAE.Results Among 80 patients with refractory postpartum hemorrhage after cesarean section treated with UAE,70 patients were included in the successful group.Ten patients with hemostatic failure were included in the failure group.Univariate analysis showed that maternal age,delivery time,gestational hypertension disease,gestational diabetes,complete placenta previa with placenta implantation,cicatricial uterus,coagulopathy,and uterine fatigue were all related factors for hemostasis failure by UAE in patients with refractory postpartum hemorrhage by cesarean section,and the differences were statistically significant(P<0.05).Conclusion The success rate of hemostasis after UAE treatment for refractory postpartum hemorrhage during cesarean section is influenced by many factors.Maternal age>35 years old,gestational hypertension,gestational diabetes,complete placenta previa with placenta implantation,cicatricial uterus,and coagulation dysfunction may increase the risk of hemostasis failure in UAE.To improve the prognosis,clinical prevention measures should be developed for these risk factors.