Usefulness of transcatheter arterial embolization for eighty-three patients with secondary postpartum hemorrhage:Focusing on difference in angiographic findings

BACKGROUND Transcatheter arterial embolization(TAE)has been widely used as an effective and a safe treatment method and was often used as an alternative to the surgical management,but there are limited studies on the efficacy and the safety for patients undergoing their secondary postpartum hemorrhage(PPH).AIM To evaluate the usefulness of TAE for secondary PPH focusing on the angiographic findings.METHODS We conducted a research from January 2008 to July 2022 on all 83 patients(mean:32 years,range:24-43 years)presented with secondary PPH and they were treated with TAE in two university hospitals.The medical records and angiography were retrospective reviewed in order to evaluate the patients’characteristics,delivery details,clinical status and peri-embolization management,angiography and embolization details,technical/clinical success and complications.The group with active bleeding sign and the group without it were also compared and analyzed.RESULTS On angiography,46(55.4%)patients showed active bleeding signs such as contrast extravasation(n=37)or pseudoaneurysm(n=8)or both(n=1),and 37(44.6%)patients showed non-active bleeding signs such as only spastic uterine artery(n=2)or hyperemia(n=35).In the active bleeding sign group there were more multiparous patients,low platelet count,prothrombin time prolongation,and high transfusion requirements.The technical success rates were 97.8%(45/46)in active bleeding sign group and 91.9%(34/37)in non-active bleeding sign group,and the overall clinical success rates were 95.7%(44/46)and 97.3%(36/37).An uterine rupture with peritonitis and abscess formation occurred to one patient after the embolization,therefore hysterostomy and retained placenta removal were performed which was a major complication.CONCLUSION TAE is an effective and a safe treatment method for controlling secondary PPH regardless of angiographic findings.

Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta

Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.

Efficacy of Uterine Artery Embolization for Patients with Postpartum Hemorrhage

Purpose: To investigate the efficacy of uterine arterial embolization (UAE) in patients with post-partum hemorrhage (PPH). Materials and Methods: The subjects were 40 women (mean age, 33 years;age range, 21 - 42 years) who underwent UAE for PPH at two institutes from June 2001 to May 2011. The rates of clinical success (avoidance of hysterectomy) and complications were calculated. Differences in related factors between primary PPH and secondary PPH and between caesarean section and vaginal delivery were examined. The risk factors associated with hysterectomy were also examined. Results: The overall clinical success rate was 90% (93% of primary PPH, 77% of secondary PPH, and 87.5% of PPH with cesarean section), and the overall complication rate was 10%. There were significant differences in time to PPH (P < 0.0001) and in blood infusion after UAE (P = 0.0158) between subtypes of primary and secondary PPH and in blood infusion before UAE (P = 0.0052) between delivery methods. The significant factors associated with hysterectomy were cesarean section (P = 0.02), severe PPH (>1000 mL bleeding, P = 0.03), and embolization of non-uterine arteries (P = 0.02).

Effect of uterine arterial embolization on the ovarian function in puerpera with postpartum hemorrhage

Objective:To observe the hemostatic effect of uterine arterial embolization in the treatment of postpartum hemorrhage and the effect on menstruation, sex hormone level, ovarian function, and pelvic floor function.Methods:A total of 45 patients with postpartum hemorrhage who were admitted in the Department of Obstetrics of our hospital from January, 2014 to June, 2016 for uterine arterial embolization were included in the study and served as the treatment group. The postoperative menstruation recovery was recorded. The hormone levels, ovarian function, and pelvic floor function before and after treatment were recorded. A total of 42 normal puerpera were served as the control group. The menstrual status of the two groups after menstruation was compared.Results: Rapid and effective hemostasis could be obtained from patients in the treatment group after treatment with hemostasis success rate of 100%. The comparison of menstruation cycle and menstruation days after treatment between the two groups was not statistically significant. The levels of E2, P, FSH, LH and PRL, ovarian function index RI and PI, pelvic floor muscle fatigue and vaginal dynamic pressure before and after 3 and 6 months had no significant difference, and there was no significant difference between the 2 groups.Conclusions: Uterine arterial embolization in the treatment of postpartum hemorrhage is effective, and has no influence on the patient's menstrual conditions, sex hormone levels, ovarian and pelvic floor functions;therefore, it is worthy of clinical application.

子宫动脉栓塞术对产后出血患者并发症及再次妊娠围生期妊娠结局的影响

目的探讨子宫动脉栓塞术(UAE)对产后出血(PPH)患者并发症及再次妊娠围生期妊娠结局的影响。方法选择2015年1月至2019年12月唐山市妇幼保健院妇接收的79例UAE治疗的PPH患者作为UAE组,选择同期在我院接受子宫动脉结扎术(UAL)治疗的78例PPH患者作为UAL组。比较两组术中及术后恢复情况、卵巢功能指标水平、术后近远期并发症发生率及再次妊娠围生期妊娠结局。通过logistic回归分析确定产后出血治疗后远期并发症发生的影响因素。结果UAE组术中失血量[(959.70±203.15)mL]、止血时间[(30.59±5.81)min]、住院时间[(7.33±1.58)d]、产后月经恢复时间[(72.14±16.42)d]均少于UAL组,产后首次月经量/妊娠前平均月经量(1.13±0.35)多于UAL组,差异均有统计学意义(P<0.05);UAL组术后抗缪勒氏管激素(AMH)、雌二醇(E_(2))水平较术前降低(P<0.05),卵泡刺激素(FSH)水平较术前增高(P<0.05),两组术前后AMH、E_(2)、FSH的差值比较,差异有统计学意义(P<0.05);UAE组近期、远期并发症发生率分别为3.80%和5.06%,均低于UAL组(P<0.05);logistic回归分析显示,治疗方式是产后出血治疗后远期并发症发生的影响因素;两组再次妊娠者瘢痕部位妊娠、自然流产、前置胎盘等围产期妊娠结局发生率比较,差异无统计学意义(P>0.05)。结论与UAL相比,UAE对PPH患者的止血更迅速,月经恢复时间更短,对卵巢功能的影响更小,近、远期并发症发生率更低。在再次妊娠者围生期妊娠结局方面,两种止血方式未见差异。

子宫动脉栓塞介入治疗产后出血中全面性护理的效果

目的:明确全面性护理在子宫动脉栓塞介入治疗产后出血中的应用效果。方法:在本院2018年1月至2022年12月时间段内接受子宫动脉栓塞介入治疗的产后出血患者中抽取50例作为研究对象,随机分为对照组和观察组,均纳入25个病例;基础护理方案用于对照组患者的护理,全面性护理方案用于观察组患者的护理;比较两组临床观察指标、护理满意度和护理效果情况。结果:观察组止血时间、手术时间、下床活动时间和住院时间短于对照组,术后出血量少于对照组,差异明显(P<0.05);观察组护理满意度高于对照组,差异明显(P<0.05);观察组一次性栓塞成功率高于对照组,并发症发生率低于对照组,差异明显(P<0.05)。结论:产后出血患者子宫动脉栓塞介入治疗中给予全面性护理服务,应用效果较好,推广应用价值高。

子宫动脉栓塞治疗急性产后出血疗效的影响因素分析

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。

基于症状管理理论的方案在产科出血介入术后患者主观症状管理中的应用研究

目的浅析症状管理理论在产科出血介入治疗术后的应用价值。方法研究基于前瞻性视角,以症状管理理论作为研究主体,参照常规综合护理,论述该理论主导下的个性化护理方案在产科出血介入治疗术后的应用价值。为此,设计样本40例,均来自本单位2012年12月至2021年12月收治的产科出血并接受介入治疗者;基于随机数字表法将20例纳入对照组,采取常规综合护理;另20例纳入观察组,采取症状管理理论主导下的个性化护理;比较两组患者在焦虑自评量表(SAS)、抑郁自评量表(SDS)、自护能力量表(ESCA)、症状发生率、护理满意度上的差异。结果干预前,两组SAS、SDS、ESCA评分之间差异无统计学意义(P>0.05);干预后,观察组的SAS、SDS评分均较之对照组更低,ESCA评分较之对照组更高,且观察组症状发生率较之对照组更低,护理满意度较之对照组更高,均差异有统计学意义(P<0.05)。结论症状管理理论主导下的个性化护理,在产科出血症状管理领域收效良好,有助于整体护理提质增效。

超选择性肾动脉栓塞治疗不同病因肾出血的疗效评估

目的评估超选择性肾动脉栓塞治疗不同病因肾出血的疗效及安全性。方法收集2018年7月至2023年6月安徽医科大学第三附属医院/合肥市第一人民医院收治的18例不同病因导致肾出血患者的临床资料,所有患者均在内科保守治疗效果不佳或要求介入治疗后采用了超选择性肾动脉栓塞治疗。观察所有患者的术中造影表现、介入栓塞治疗效果及介入术后并发症发生情况。结果18例患者术中造影表现均为阳性,其中,11例患者表现为单纯造影剂聚集或外溢;2例患者表现为造影剂外溢合并动静脉畸形;1例患者表现为造影剂外溢合并假性动脉瘤;4例患者表现为靶血管增粗,分支杂乱,部分可见瘤样扩张。18例患者术后活动性出血停止,肉眼血尿逐渐好转至消失,肾周血肿逐渐吸收,术后血红蛋白水平高于术前(P﹤0.05),治疗有效率为100%。2例患者术后发生轻度栓塞后综合征。所有患者均未出现严重并发症。除了2例透析患者外,其余16例患者术后肾功能均正常。结论超选择性肾动脉栓塞治疗肾出血的疗效显著,创伤性小,对肾功能无明显损伤,安全性高,可作为内科保守治疗效果不佳的各种病因所致肾出血患者的首选治疗方法。

急诊子宫动脉栓塞术治疗产后大出血的疗效

目的 分析急诊子宫动脉栓塞术(UAE)对产后大出血患者凝血功能、生育功能的影响。方法将我院急诊科收治的120例产后大出血患者随机分为对照组和观察组,每组60例。对照组采用卡前列素氨丁三醇注射液治疗,观察组采用UAE治疗,对比评价两组患者凝血功能、生育功能(卵巢动脉血流信号)及不良事件发生情况。结果 干预后观察组的凝血酶时间、活化部分凝血活酶时间、纤维蛋白原、血小板计数等凝血功能指标均明显改善,且观察组优于对照组(P<0.05);观察组脉搏峰值速度明显高于对照组,并且其阻力指数值显著低于对照组(P<0.05);两组不良事件发生情况比较,P<0.05。结论 急诊子宫动脉栓塞术治疗产后大出血患者,可保持良好卵巢动脉血流信号,明显改善患者凝血功能。

子宫动脉栓塞术治疗严重产后出血的临床效果

目的探讨子宫动脉栓塞术治疗严重产后出血的临床效果。方法选取2022年2月至2023年6月烟台市北海医院收治的80例严重产后出血患者,按照随机数字表法分为对照组和研究组,每组各40例。对照组采用宫腔球囊压迫止血治疗,研究组采用子宫动脉栓塞术治疗,比较两组治疗效果及术后并发症发生情况。结果研究组治疗总有效率为97.50%,高于对照组的82.50%(P<0.05);研究组术后并发症总发生率为7.50%,低于对照组的30.00%(P<0.05)。结论子宫动脉栓塞术治疗严重产后出血的临床效果较好,能够提高治疗有效率,降低术后并发症发生率。

Interventional treatment of pulmonary arteriovenous malformations

Pulmonary arteriovenous malformations(PAVM) are congenital vascular communications in the lungs.They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered.These patients are typically hypoxaemic with exercise intolerance and are at high risk of paradoxical emboli to the brain and other organs.These malformations are most commonly seen in hereditary haemorrhagic telangiectasia(HHT)(Mb.Osler-Weber-Rendu syndrome).Nowadays,the generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations.It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success,high effectiveness and low morbidity and mortality.Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level.Embolization is a well-established method of treating PAVM,with a significant effect on oxygenation of the blood.Screening for PAVM in patients at risk is recommended,especially in patients with HHT.

子宫动脉栓塞术治疗难治性产后出血的临床分析

目的:探讨子宫动脉栓塞术(UAE)治疗难治性产后出血(RPPH)的时机以及可能失败的原因。方法:选择2012年1月至2020年12月因RPPH行UAE治疗的85例患者进行回顾性分析,按照UAE是否止血成功分为UAE失败组((印)n(正)=25)和成功组((印)n(正)=60),收集两组患者的年龄、体质量指数(BMI)、既往剖宫产史、多胎妊娠、是否并发子痫前期、分娩方式、产后出血原因、出血量、是否发生弥散性血管内凝血(DIC)、休克指数、UAE前血红蛋白(Hb)、血小板计数(PLT)、纤维蛋白原(Fib)、使用促子宫收缩药物、决定介入手术至转运到介入手术室时间及手术时间、异常侧支血管、卵巢动脉供血等指标,并进行比较分析。结果:(1)85例RPPH患者采取UAE治疗成功率70.59%,失败组和成功组患者的年龄、BMI、孕产次、多胎妊娠及是否并发子痫前期比较,差异无统计学意义((印)P(正)>0.05),失败组与成功组比较,在剖宫产手术史上差异有统计学意义((印)P(正)<0.05)。(2)失败组和成功组的患者,在分娩方式、是否发生胎盘植入、血管介入手术前大出血量、休克指数、Fib(1.58±0.93 g/L vs.2.99±2.47 g/L)、介入手术持续时间、子宫是否存在侧支血管供血方面比较,差异均有统计学的意义((印)P(正)<0.05)。另一方面,宫缩乏力至大出血、决定介入至患者转运至介入手术室时间、有无使用多种促子宫收缩剂、DIC、造影发现有卵巢动脉显影以及在介入手术前Hb(87.88±18.00 g/L vs.80.97±16.61 g/L)、PLT[(112.52±33.10)×10^(9)/L vs.(131.00±58.38)×10^(9)/L]方面,两组间比较差异无统计学意义((印)P(正)>0.05)。结论:UAE是治疗RPPH的有效方法,但对于胎盘植入导致的RPPH,UAE止血失败率较高。UAE前产后出血量多、休克指数高,UAE的失败率高。有异常侧支血管供血的RPPH患者单一的UAE并不能达到良好的止血效果,需联合其它止血方式。

前置胎盘剖宫产产后出血麦角新碱联合手术止血效果及对血D-二聚体影响

目的:探讨麦角新碱联合止血手术对前置胎盘剖宫产产后出血患者止血效果及D-二聚体(D-D)的影响。方法:回顾性分析本院2019年1月-2022年1月收治的前置胎盘剖宫产产后出血患者120例临床资料,均采用子宫动脉栓塞术或宫腔球囊压迫止血术治疗,术后麦角新碱辅助治疗为联合组(n=76)、非麦角素治疗对照组(n=44)。比较两组临床指标、止血效果、应激状态、凝血功能指标,随访3个月不良反应情况。结果:联合组止血有效率(96.1%)高于对照组(84.1%),恶露持续时间(16.0±2.1d)、产后2 h内出血量(1240.4±110.2ml)、产后2~24h出血量(513.9±52.2 ml)、住院时间(7.5±1.4d)均低于对照组(26.5±3.5d、1610.3±150.8 ml、745.2±40.7 ml、10.9±2.7d);治疗后两组血清皮质醇、去甲肾上腺素、肾上腺素水平均降低且联合组低于对照组,两组凝血酶原时间、凝血活酶时间、纤维蛋白原、D-D水平均降低且联合组低于对照组;不良反应发生率联合组(5.3%)低于对照组(18.2%)(均P<0.05)。结论:麦角新碱联合止血手术治疗前置胎盘剖宫产产后出血止血效果提高,可有效改善产妇临床指标和凝血功能,降低D-D水平,控制应激状态,且安全性高。

Successful treatment of combined vaginal and broad ligament hematoma using pelvic pressure pack and arterial embolization

Objective:To assess using the pelvic pressure pack as temporizing treatment for combined vaginal and broad ligament hematoma before selective arterial embolization could be undertaken.Methods:A 29-year-old woman was transferred because of a 10cm right upper vaginal hematoma found shortly after the spontaneous delivery of a 3400g infant at term.Following evacuation of the clots,the patient’s condition deteriorated with the appearance of a painful right pelvic mass,displacing the uterus.At laparotomy,the hematoma extended between the folds of the broad ligament into the pelvic sidewall.After evacuation of the clots,hemostasis failed despite subtotal hysterectomy.Eventually a pressure pack created from joined gauze rolls was used to fill up the pelvic cavity and achieved hemostasis before abdominal closure.When the vaginal pack was removed 30 hours later,vaginal bleeding recurred,and bilateral hypogastric embolization was performed with Gianturco coils.Results:The patient was successfully treated by this way and discharged uneventfully.Conclusion:In combined vaginal and broad ligament hematoma,pelvic pressure pack can be used to ensure maternal survival until definitive treatment with angiographic embolization.

Surgical first aid and nursing care of a parturient with massive hemorrhage in natural delivery

Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterectomy.Results:The uterus was successfully removed and the bleeding was successfully stopped.It was transferred to the ICU under general anesthesia.Conclusion:For pregnant women with postpartum massive bleeding and hemorrhagic shock and diffuse intravascular coagulation(DIC),targeted surgical treatment and complete operating room emergency care are of great significance to save maternal lives.

Glubran-2胶用于子宫动脉栓塞治疗产后出血伴凝血功能障碍患者子宫动脉假性动脉瘤

目的 观察以Glubran-2胶行子宫动脉栓塞(UAE)治疗产后出血伴凝血功能障碍患者子宫动脉假性动脉瘤(UAP)的价值。方法 回顾性纳入13例接受Glubran-2胶UAE治疗的产后出血伴凝血功能障碍UAP患者,包括产后即刻出血8例、迟发性产后出血5例;共17个UAP,其中10例1个、2例2个、1例3个UAP;观察UAE技术成功率、临床治疗成功率、复发率、并发症率、产后恢复月经来潮时间及UAE后生育情况。结果 13例UAE中,11例采用Glubran-2胶联合明胶海绵颗粒进行栓塞、2例单独以Glubran-2胶进行栓塞,Glubran-2胶用量为0.3~2.2 ml/例;UAE技术成功率和临床治疗成功率均为100%。UAE后随访3~75个月,未见严重并发症及复发出血;2例于UAE后2日发热,经抗感染治疗后好转。13例均于产后2~6个月、中位时间4个月恢复月经来潮,且均无再生育意愿。结论 以Glubran-2胶行UAE治疗产后出血伴凝血功能障碍患者UAP安全、有效。

介入栓塞治疗在难治性产后出血治疗中的应用

目的探讨难治性产后出血发生严重凝血功能障碍时介入栓塞治疗的可能性及成功率。方法选择天津市第三中心医院2015年1月至2022年2月收治的难治性产后出血介入栓塞治疗的38例病例,按患者的凝血功能指标将其分为弥散性血管内凝血(DIC)组(14例)和非DIC组(24例),比较两组的凝血功能指标、出血量、血红蛋白、DIC的Takao评分和首次介入栓塞治疗失败率。结果造成38例患者产后出血的原因有:宫缩乏力18例,羊水栓塞3例,胎盘早剥3例,剖宫产后盆腔血肿3例,前置胎盘2例,胎盘植入2例(其中1例为胎盘植入残留宫腔),双胎妊娠2例,产褥期感染2例,急性脂肪肝1例,产褥期子宫动静脉瘘1例,剖宫产术后阴道分娩(VBAC)子宫破裂1例。其中3例患者因子宫切除后仍有出血而实施的介入下栓塞治疗。与非DIC组相比,DIC组介入治疗前凝血功能更差,出血量更多(mL:2878.57±1115.75比1657.08±1027.25)、血红蛋白更低(g/L:68.00±28.46比88.96±23.65),DIC评分更高(分:11.57±3.80比3.25±2.54),差异均有统计学意义(均P<0.05)。两组都成功实施介入栓塞治疗止血,首次失败率DIC组高于非DIC组〔28.57%(4/14)比8.33%(2/24)〕,差异有统计学意义(P<0.05),两组再次行介入栓塞治疗成功率均达100%。结论介入栓塞治疗在难治性产后出血发生严重凝血功能障碍时应用也十分成功。

剖宫产难治性产后出血患者UAE术止血效果的影响因素

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。

卡前列素氨丁三醇注射液联合Bakri球囊宫腔填塞术治疗难治性产后出血的临床效果

目的探讨卡前列素氨丁三醇注射液联合Bakri球囊宫腔填塞术治疗难治性产后出血的临床效果。方法选取2020年3月至2022年3月我院收治的60例难治性产后出血患者为研究对象,按照随机数字表法将其分为对照组和观察组,各30例。对照组给予子宫动脉栓塞术治疗,观察组给予卡前列素氨丁三醇注射液联合Bakri球襄宫腔填塞术治疗。比较两组的临床指标、卵巢功能指标、月经情况、子宫切除率、产褥感染率及生活质量。结果观察组的止血时间短于对照组,总失血量、住院费用少于对照组(P<0.05)。治疗后42 d,观察组的卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平高于对照组(P<0.05)。观察组的首次月经恢复时间短于对照组(P<0.05);两组的首次月经量、月经周期及月经天数比较,差异无统计学意义(P>0.05)。两组的子宫切除率、产褥感染率比较,差异无统计学意义(P>0.05)。治疗后42 d,观察组的健康调查简表(SF-36)各维度评分高于对照组(P<0.05)。结论卡前列素氨丁三醇注射液联合Bakri球囊宫腔填塞术用于难治性产后出血的治疗中,可快速止血,减少患者失血量,节省住院费用,促进月经恢复,提高生活质量。