子宫动脉栓塞治疗急性产后出血疗效的影响因素分析

Analysis of factors influencing the curative effect of uterine artery embolization for acute postpartum hemorrhage

目的探讨子宫动脉栓塞(UAE)治疗产后出血疗效的影响因素。方法收集2017年6月至2021年12月于合肥市第三人民医院就诊的95例产后出血患者的临床资料,分析可能影响UAE疗效的因素。结果95例产后出血患者经介入治疗后,成功83例,失败12例,有效率为87.3%。失败组患者瘢痕子宫、盆腔手术、妊娠期并发症、术前总失血量、宫腔球囊填塞情况与成功组患者比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,盆腔手术史、瘢痕子宫史、妊娠期并发症及术前总失血量﹥1800 ml均是UAE治疗产后出血疗效的影响因素(P﹤0.05)。结论盆腔手术史、瘢痕子宫史、妊娠期并发症及术前总失血量﹥1800 ml均是影响UAE治疗产后出血临床疗效的独立危险因素,临床医师应全面识别并监测产妇危险因素,降低产后出血发生率,提高产妇围产期身体健康水平,促进胎儿顺利娩出。

Objective To explore the influencing factors of uterine artery embolization(UAE)in the treatment of postpartum hemorrhage.Method Clinical data of 95 patients with postpartum hemorrhage treated in the Third People's Hospital of Hefei from June 2017 to December 2021 were collected to analyze the factors that may affect the efficacy of UAE.Result After interventional treatment of 95 patients with postpartum hemorrhage,83 cases succeeded and 12 cases failed,the effective rate was 87.3%.Compared with the successful group,there were statistically significant differences in cicatric uterus,pelvic surgery,pregnancy complications,preoperative total blood loss and uterine balloon tamponade in the failed group(P<0.05).The results of multi-factor analysis showed that the pelvic surgery history,uterine scar history,pregnancy complications and preoperative total blood loss>1800 ml were all influencing factors of UAE treatment for postpartum hemorrhage(P<0.05).Conclusion Pelvic surgery history,uterine scar history,complications during pregnancy and total blood loss>1800 ml before operation are all independent factors influencing the clinical efficacy of UAE in the treatment of postpartum hemorrhage.Clinicians should comprehensively identify and monitor maternal risk factors,reduce the incidence of postpartum hemorrhage,improve the perinatal health level of women,and promote the smooth delivery of the fetus.