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Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta 被引量:10
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作者 Zhi-wei Wang Xiao-guang Li +4 位作者 Jie Pan Xiao-bo Zhang Hai-feng Shi Ning Yang Zheng-yu Jin 《Chinese Medical Sciences Journal》 CAS CSCD 2016年第4期228-232,共5页
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 re... 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. 展开更多
关键词 uterine ARTERY EMBOLIZATION postpartum hemorrhage PLACENTA accrete
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Efficacy of Uterine Artery Embolization for Patients with Postpartum Hemorrhage 被引量:1
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作者 Young Ho Choi Yasutaka Baba +3 位作者 Shunichiro Ikeda Young Ho So Sadao Hayashi Masayuki Nakajo 《Open Journal of Radiology》 2013年第2期51-55,共5页
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... 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). 展开更多
关键词 postpartum hemorrhage uterine ARTERY EMBOLIZATION UTERUS Preservation
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Evaluation of process management of postpartum hemorrhage due to uterine atony 被引量:1
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作者 Iris Holzer Rainer Lehner 《Open Journal of Obstetrics and Gynecology》 2013年第7期514-519,共6页
Objective: To evaluate the management process and the guidelines for management of postpartum hemorrhage due to uterine atony at the General Hospital Vienna, Medical University Vienna. Material and Methods: A retrospe... Objective: To evaluate the management process and the guidelines for management of postpartum hemorrhage due to uterine atony at the General Hospital Vienna, Medical University Vienna. Material and Methods: A retrospective analysis was carried out on all 24 cases of postpartum hemorrhage due to uterine atony with an estimated blood loss of more than 800 mL, in which standardized guidelines were obtained. We included all women who gave birth at the General Hospital of Vienna, the Medical University Vienna, during the period from January 1st 2003 and December 31st 2009 and who suffered blood loss 800 mL at minimum due to uterine atony. Results: The guidelines were in use for 14% - 71%. The average blood loss of the 24 cases with uterine atony was 1342 mL. Conclusion: The management process of postpartum hemorrhage due to uterine atony deviates from the hospital’s guidelines in many cases. 展开更多
关键词 postpartum hemorrhage uterine Atony MANAGEMENT PROCESS
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Observation on the effect of carbetocin in preventing postpartum hemorrhage caused by uterine inertia 被引量:3
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作者 Hong-Li Zhang Rui Bai 《Journal of Hainan Medical University》 2017年第1期131-134,共4页
Objective:To explore the effect of carbetocin in preventing postpartum hemorrhage caused by uterine inertia.Methods: A total of 256 puerpera with single full-term delivery who were admitted in our hospital from May, 2... Objective:To explore the effect of carbetocin in preventing postpartum hemorrhage caused by uterine inertia.Methods: A total of 256 puerpera with single full-term delivery who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into the vaginal delivery group and cesarean section group with 128 cases in each group according to the delivery ways. According to the medication, each group was divided into the carbetocin group and oxytocin group with 64 cases in each group. After fetus delivery, the puerpera in the carbetocin group were given intravenous injection of carbetocin (100μg), while the puerpera in the oxytocin group were given intravenous injection of oxytocin (10 U)+0.9% NaCl (500 mL) for 2 h. The amount of bleeding at delivery, 2 h and 24 h after delivery in each group was observed. A volume of 5 mL elbow venous blood before delivery and 24 h after delivery was extracted. The automatic blood cell analyzer was used to detect the decreased value of 24 h hemoglobin in each group. The coagulation detector was used to detect PT, APTT, and FIB before delivery and 24 h after delivery. The blood pressure and heart rate before and after medication in each group were observed.Results: The amount of bleeding at delivery, 2 h and 24 h after delivery in the carbetocin group was signiifcantly less than that in the oxytocin group (P<0.05). The decreased value of 24 h hemoglobin after delivery in the carbetocin group was signiifcantly less than that in the oxytocin group (P<0.05). The indicators of coagulation function 24 h after delivery in each group were not signiifcantly changed (P>0.05). The heart rate and blood pressure after medication in each group were not significantly changed when compared with before medication (P>0.05).Conclusions:Carbetocin can effectively prevent the postpartum hemorrhage caused by uterine inertia, and is safe and effective in application of vaginal delivery and cesarean section;therefore, it deserves to be widely recommended in the clinic. 展开更多
关键词 CARBETOCIN OXYTOCIN uterine INERTIA postpartum hemorrhage Prevention
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Correlation of large conductance Ca2+ activated K+ channelα andβ subunit expression in uterine smooth muscle with the postpartum hemorrhage induced by uterine inertia
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作者 Yong-Rui Wang Liang Tang +1 位作者 Cheng-Jian Xie Xue-Qin Liu 《Journal of Hainan Medical University》 2018年第9期44-47,共4页
Objective:To study the correlation of large conductance Ca2+ activated K+ channel (BKCa)α andβ subunit expression in uterine smooth muscle with the postpartum hemorrhage induced by uterine inertia.Methods: The puerp... Objective:To study the correlation of large conductance Ca2+ activated K+ channel (BKCa)α andβ subunit expression in uterine smooth muscle with the postpartum hemorrhage induced by uterine inertia.Methods: The puerperae who underwent cesarean section and had postpartum hemorrhage induced by uterine inertia in Panzhihua Women and Children Health Hospital between March 2015 and May 2017 were selected as the hemorrhage group of the study, and the puerperae who underwent cesarean section and were without postpartum hemorrhage in Panzhihua Women and Children Health Hospital during the same period were selected as the control group. Proper amount of uterine muscle tissue was collected during the cesarean section to measure the expression of BKCaα andβ subunits and the levels of contraction-related proteins in uterine muscle as well as the contraction characteristic parameters of the uterine muscle.Results: The mRNA expression and protein expression of BKCaα andβ subunits in uterine muscle tissue of hemorrhage group were significantly higher than those of control group;the contraction amplitude, contraction frequency and contraction activity of uterine muscle tissue as well as the OTR, COX2, CX43 and HSP27 levels in uterine muscle tissue of hemorrhage group were significantly lower than those of control group;the BKCaα andβ subunit expression in uterine muscle tissue of hemorrhage group were negatively correlated with the contraction amplitude, contraction frequency and contraction activity as well as the OTR, COX2, CX43 and HSP27 levels.Conclusion: The high expression of BKCa in uterine smooth muscle can reduce the uterine muscle contractility and decrease the levels of contraction-related proteins, and it is closely related to the occurrence of postpartum hemorrhage induced by uterine inertia. 展开更多
关键词 postpartum hemorrhage INDUCED by uterine inertia LARGE CONDUCTANCE CA2+ ACTIVATED K+ channel uterine contractility Contraction-related protein
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Effect of uterine water bag + gauze packing on coagulation function and stress response of patients with postpartum hemorrhage
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作者 Li Zeng 《Journal of Hainan Medical University》 2018年第13期46-49,共4页
Objective:To study the effect of uterine water bag + gauze packing on coagulation function and stress response of patients with postpartum hemorrhage.Methods: Patients who gave birth and had postpartum hemorrhage in t... Objective:To study the effect of uterine water bag + gauze packing on coagulation function and stress response of patients with postpartum hemorrhage.Methods: Patients who gave birth and had postpartum hemorrhage in the hospital between June 2014 and May 2017 were chosen as the research subjects and divided into the combined group who received uterine water bag + gauze packing hemostasis, the control group 1 who received uterine water bag hemostasis and the control group 2 who received gauze packing hemostasis. The overall clinical efficacy was observed, and the serum levels of blood coagulation function indexes and stress response indexes were determined before treatment and after hemostatic treatment.Results: The intraoperative blood loss, postoperative blood loss and the change of hemoglobin before treatment and after hemostatic treatment of combined group were less than those of control group 1 and control group 2;compared with those of same group before treatment, serum APTT and PT levels as well as FDP, ET-1, ANG-II, ALD, NE, E, TNF-α, IL-6, ICAM1 and VCAM1 contents after hemostatic treatment were significantly lower whereas PAI-1 and AT-III contents were significantly higher, and serum APTT and PT levels as well as FDP, ET-1, ANG-II, ALD, NE, E, TNF-α, IL-6, ICAM1 and VCAM1 contents of combined group after hemostatic treatment were significantly lower than those of control group 1 and control group 2 whereas PAI-1 and AT-III contents were significantly higher than those of control group 1 and control group 2.Conclusion: uterine water bag + gauze packing treatment of postpartum hemorrhage can achieve better efficacy than monotherapy and improve the coagulation function and stress response. 展开更多
关键词 postpartum hemorrhage uterine water BAG GAUZE packing COAGULATION function Stress response
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Effect of uterine arterial embolization on the ovarian function in puerpera with postpartum hemorrhage
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作者 Yan-Xian Deng 《Journal of Hainan Medical University》 2017年第12期71-74,共4页
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.Meth... 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. 展开更多
关键词 postpartum hemorrhage uterine arterial EMBOLIZATION Sex HORMONE OVARIAN function
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An old uterine rupture repaired 2 months postpartum using laparoscopy aided by hysteroscopy: A case report
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作者 Yuichiro Kizaki Kouki Samejima +2 位作者 Shigetaka Matsunaga Tomonori Nagai Yasushi Takai 《Laparoscopic, Endoscopic and Robotic Surgery》 2022年第4期153-157,共5页
With an incidence of 0.005%,unscarred uterine rupture is extremely rare.It is difficult to diagnose uterine rupture because of the absence of characteristic clinical symptoms.Here,we report a rare case of a 31-year-ol... With an incidence of 0.005%,unscarred uterine rupture is extremely rare.It is difficult to diagnose uterine rupture because of the absence of characteristic clinical symptoms.Here,we report a rare case of a 31-year-old woman with a uterine rupture that was accurately diagnosed and repaired by laparoscopy and hysteroscopy on postpartum day 69.The patient recovered uneventfully and was discharged on postoperative day 4.Three months after surgery,pelvic magnetic resonance imaging was performed,which confirmed wound repair.In women with a stable condition,laparoscopy with hysteroscopy could be an alternative choice for the diagnosis and treatment of suspected uterine rupture;however,more substantial studies are needed to confirm this surgical approach. 展开更多
关键词 HYSTEROSCOPY Laparoscopic surgery uterine rupture postpartum hemorrhage uterine preservation
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Oxytocin Abuse and Postpartum Hemorrhage
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作者 Loutfi Guennoun Abdelmounaim Mohammed Khouchoua +9 位作者 Nouha Nhiri Naouale Biougnache Mohamed Adnane Rhaidouni Ouassila Laouji Fatima El Hadraoui Safae Habib Rabbi Omar El Ayoubi Omar Alaoui Samir Messnan Said Lafkir 《Open Journal of Obstetrics and Gynecology》 CAS 2022年第12期1320-1327,共8页
Among the most consolidated dogmas in obstetrics, we have the essential role of oxytocin during: labor by regulating, consolidating uterine contractions, by supporting the expulsive efforts of the patient during child... Among the most consolidated dogmas in obstetrics, we have the essential role of oxytocin during: labor by regulating, consolidating uterine contractions, by supporting the expulsive efforts of the patient during childbirth and after childbirth by preventing postpartum hemorrhage. But what challenged us to conduct our study is the large and increasing number of surgical operations for postpartum hemorrhage in patients who received oxytocin during labor. We assumed that the generalization use of oxytocin in all patients during labor is probably responsible of this increasing rate of incidents. To verify this assumption, we carried out a prospective randomized comparative study, involving 3990 pregnant patients admitted at the start of labor at term, with no contraindication for giving birth by normal ways, during a period of 10 months (January-October 2022). The patients have been divided into 2 groups. The first group comprises 1991 patients who were placed on admission on a glucose serum infusion with 4 ampoules of a non-anticholinergic musculotropic antispasmodic: “Hydrated phloroglucinol + trimethylphloroglucinol” (Each ampoule contains 40 mg of hydrated phloroglucinol and 0.04 mg of trimethylphloroglucinol) instead of receiving oxytocin during the active phase of their labor and a second group consisting of 1999 patients who received oxytocin during the active phase of their labor. The results were very surprising and contrary to the already consolidated evidence in our specialty. Indeed, the rate of postpartum hemorrhages was 10 patients (0.5%) in the 1st group vs 30 patients (1.5%) in the 2nd group, 9 patients (0.4%) presented fetal heart rate abnormalities in the 1st group vs 90 (4.5%) in the 2nd group, 8 cases (0.4%) of dynamic dystocia in the 1st group vs 132 cases (6.6%) in the 2nd group and 99 caesareans (5%) in the 1st group vs 299 (15%) in the 2nd group. Against all expectations the results were very surprising, with more details in the article. 展开更多
关键词 OXYTOCIN ANTISPASMODIC postpartum hemorrhage uterine Inertia Dynamic Dystocia Cesarean Section Abnormal Fetal Heart Rate
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The Active Management of Postpartum Uterine Atony—A Checklist Based Approach
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作者 Rachael Bailey Michael R. Foley +6 位作者 Nicole Hall Adiel Fleischer Mary D’Alton Gary A. Dildy Michael A. Belfort Gary D. Hankins Steven L. Clark 《Open Journal of Obstetrics and Gynecology》 2016年第11期646-653,共9页
Uterine atony remains the major cause of postpartum hemorrhage, and of death from postpartum hemorrhage in the United States. While existing guidelines outlining a general approach to postpartum hemorrhage are useful,... Uterine atony remains the major cause of postpartum hemorrhage, and of death from postpartum hemorrhage in the United States. While existing guidelines outlining a general approach to postpartum hemorrhage are useful, recent data suggest that greater specificity may be necessary to significantly impact mortality. We present a highly specific and methodical approach to the management of uterine atony, which addresses what we believe to be the most common cause of preventable maternal hemorrhagic death in the US—lack of an intensive, focused approach to atony and perseverance with therapies that are not working. This protocol should result in cessation of hemorrhage by medical or surgical means within 1 hour of diagnosis. We then apply this protocol to a number of illustrative cases of maternal death due to atony. An approach involving the active management of uterine atony may assist clinicians in avoiding severe morbidity and mortality from uterine atony. 展开更多
关键词 postpartum hemorrhage Obstetric hemorrhage uterine Atony
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Oxytocin and Uterine Atony during Cesarean Section 被引量:1
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作者 Loutfi Guennoun Abdelmounaim A. Rjafallah +10 位作者 N. Nhiri N. Biougnache R. Benafitou R. Barka Y. Bouferma S. Habib Rabbi O. El Ayoubi O. Alaoui S. Mesnane M. Khouchoua S. Lafkir 《Open Journal of Obstetrics and Gynecology》 2021年第6期815-822,共8页
In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical support... In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical supports, to make the exercise of our specialty as stripped of pitfalls as possible. Our work is summarized in a prospective comparative study, aimed at evaluating the existence or not of a difference between the administration of oxytocin just before the hysterotomy in a cesarean section and its administration after fetal extraction. We used a set of criteria to include patients in our study. This study took place over a period of one year (2020) in the Mother and Child regional center, in Meknes Imperial city, Morocco, involving a total number of 364 patients. With a group A comprising 176 patients 48% (176/364) who received oxytocin just before the hysterotomy and a group B of 188 patients 52% (188/364) who received it classically after fetal extraction. The difference was very significant as detailed in the article. Conclusion: the very convincing results of our study and the difference between the two groups, allowed us to demonstrate the effectiveness of our process and to endorse its use in our routine practice, with the perspective of conducting a prospective randomized study on a larger series. 展开更多
关键词 OXYTOCIN Cesarean Section uterine Atony postpartum hemorrhage
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Surgical first aid and nursing care of a parturient with massive hemorrhage in natural delivery
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作者 Miao-Miao Chen Yong-Chao He +2 位作者 Meng-Yuan Pei Hua-Ting Zhang Xiao-Yu Liu 《Nursing Communications》 2022年第1期40-42,共3页
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 hysterect... 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. 展开更多
关键词 postpartum bleeding hemorrhagic shock uterine artery embolization HYSTERECTOMY DIC emergency care in the operating room
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基于循证案例分析的优质护理对宫缩乏力性产后出血的护理效果
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作者 刘小玮 王蕊 何珍 《川北医学院学报》 CAS 2024年第4期569-572,共4页
目的:探讨基于循证案例分析的优质护理对宫缩乏力性产后出血患者的护理效果。方法:选取104例宫缩乏力性产后出血患者,按照护理方式不同将患者分为对照组和观察组,两组各52例。对照组给予常规护理;观察组在常规护理基础上使用基于循证案... 目的:探讨基于循证案例分析的优质护理对宫缩乏力性产后出血患者的护理效果。方法:选取104例宫缩乏力性产后出血患者,按照护理方式不同将患者分为对照组和观察组,两组各52例。对照组给予常规护理;观察组在常规护理基础上使用基于循证案例分析的优质护理,对比两组患者的出血情况、临床疗效、凝血及纤溶功能指标水平、并发症发生情况、生活质量。结果:观察组患者产后0.5、2、12及24 h出血量均少于对照组,止血耗时短于对照组(P<0.05);干预后,观察组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)水平均低于对照组,纤维蛋白原(FIB)水平高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05);观察组患者SF-36量表各维度评分均高于对照组(P<0.05)。结论:基于循证案例分析的优质护理可有效降低宫缩乏力性产后出血患者的出血量,缩短止血时间,改善凝血及纤溶功能,减少并发症发生率,提高生活质量。 展开更多
关键词 宫缩乏力 产后出血 循证案例分析 优质护理 凝血功能 生活质量
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卡前列素氨丁三醇与麦角新碱预防剖宫产产妇出血及对子宫复旧的作用
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作者 余亚婷 李思梅 张静雯 《中国药物应用与监测》 CAS 2024年第3期244-247,共4页
目的观察卡前列素氨丁三醇与麦角新碱预防剖宫产产妇出血及对子宫复旧的作用。方法该项目为回顾性研究,选取2019年3月至2024年1月在合肥市第一人民医院行剖宫产术的产妇118例,根据产后药物干预方案分为A组(n=48,采用麦角新碱治疗)、B组(... 目的观察卡前列素氨丁三醇与麦角新碱预防剖宫产产妇出血及对子宫复旧的作用。方法该项目为回顾性研究,选取2019年3月至2024年1月在合肥市第一人民医院行剖宫产术的产妇118例,根据产后药物干预方案分为A组(n=48,采用麦角新碱治疗)、B组(n=33,采用卡前列素氨丁三醇治疗)和C组(n=37,采用卡前列素氨丁三醇联合麦角新碱治疗)。收集3组患者临床资料,比较3组患者产后出血量、恶露持续时间、住院时间、产后出血发生率及子宫复旧情况,评估3组产妇药品不良反应。结果A组和B组产后2 h及24 h出血量、恶露持续时间和住院时间分别为[A:(343.58±49.32)mL,(426.35±68.65)mL,(18.25±3.21)d,(5.26±0.25)d;B:(341.63±54.27)mL,(431.25±63.59)mL,(17.98±2.66)d,(5.34±0.32)d]比较,差异无统计学意义(t=0.168,0.325,0.398,1.261,P=0.867,0.746,0.692,0.211)(P>0.05);C组产后2 h及24 h出血量,恶露持续时间和住院时间分别为(215.65±42.36)mL,(301.36±50.35)mL,(14.21±2.14)d,(4.21±0.43)d,均少于A组和B组(C vs A:t=16.968,13.030,9.465,20.289,均P<0.001;C vs B:t=15.267,12.372,8.070,19.950,均P<0.001)。3组产后出血发生率分别为4.17%,30.3%,0,差异无统计学意义(P=0.624)。A组和B组产后3 d、5 d的子宫下降程度分别为[A:(2.09±0.18)cm,(4.03±0.25)cm;B:(2.16±0.39)cm,(4.15±0.34)cm],均差异无统计学意义(t=1.088,1.831,P=0.280,0.071),C组以上指标分别为(2.94±0.23)cm,(4.89±0.29)cm,均大于A组和B组(C vs A:t=20.460,17.154,均P<0.001;C vs B:t=19.177,15.077,均P<0.001)。A,B,C组患者总不良反应发生率分别为14.58%,9.09%,24.32%,差异无统计学意义(χ^(2)=3.134,P=0.209)。结论卡前列素氨丁三醇与麦角新碱均可有效促进子宫收缩,预防产后出血,促进子宫复旧,两者联合可能具有协同作用,可更进一步的提高临床效果。 展开更多
关键词 卡前列素氨丁三醇 麦角新碱 剖宫产 产后出血 子宫复旧
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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
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作者 周巾 张英杰 +2 位作者 张翠杰 李亚光 肖凡 《安徽医学》 2024年第3期275-279,共5页
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PP... 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。 展开更多
关键词 子宫动脉栓塞术 子宫动脉结扎术 产后出血 并发症 再次妊娠 妊娠结局
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子宫动脉栓塞介入治疗产后出血中全面性护理的效果
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作者 成殿芹 《黔南民族医专学报》 2024年第1期98-101,共4页
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... 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。 展开更多
关键词 子宫动脉栓塞介入 产后出血 全面性护理 应用价值
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子宫背带缝合术联合子宫动脉上行支结扎术治疗难治性产后出血的临床效果
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作者 陈静 《实用妇科内分泌电子杂志》 2024年第7期16-18,共3页
目的探究难治性产后出血联合应用子宫背带缝合术、子宫动脉上行支结扎术的临床效果。方法选取本院妇产科300例难治性产后出血患者为研究对象,根据抽签法分为两组,各150例。试验组行子宫背带缝合术辅助子宫动脉上行支结扎术,对照组单纯... 目的探究难治性产后出血联合应用子宫背带缝合术、子宫动脉上行支结扎术的临床效果。方法选取本院妇产科300例难治性产后出血患者为研究对象,根据抽签法分为两组,各150例。试验组行子宫背带缝合术辅助子宫动脉上行支结扎术,对照组单纯行子宫动脉上行支结扎术,比较两组手术疗效。结果试验组手术各指标、术后卵巢血流动力学指标优于对照组,并发症总发生率低于对照组(P<0.05)。结论难治性产后出血患者应用子宫背带式缝合术结合子宫动脉上行支结扎术可行性高,能缩短术后康复时间,并发症发生率低,还可减轻对卵巢组织的刺激,建议推广。 展开更多
关键词 子宫动脉上行支结扎术 临床预后 子宫背带缝合术 难治性产后出血
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马来酸麦角新碱联合卡前列素氨丁三醇对宫缩乏力性产后出血的防治效果 被引量:1
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作者 傅鑫 郭淼 武海雨 《罕少疾病杂志》 2024年第3期76-77,共2页
目的探究马来酸麦角新碱联合卡前列素氨丁三醇在宫缩乏力性产后出血防治中的应用效果,以期为临床提供一种更安全有效的治疗方案。方法收集2020年3月至2022年3月在本院就诊的自然分娩产妇82例,采用随机数字表法分组,即对照组、观察组,均4... 目的探究马来酸麦角新碱联合卡前列素氨丁三醇在宫缩乏力性产后出血防治中的应用效果,以期为临床提供一种更安全有效的治疗方案。方法收集2020年3月至2022年3月在本院就诊的自然分娩产妇82例,采用随机数字表法分组,即对照组、观察组,均41例。对照组予以缩宫素注射液,观察组在对照组的基础上增加马来酸麦角新碱联合卡前列素氨丁三醇。统计两组产妇产后出血情况、宫底情况及不良反应等。结果观察组产妇产后2h、12h、24h出血量、产后出血发生率、宫底高度、恶露持续时间、宫腔积血发生率均低于对照组(P<0.05);两组不良反应发生率比较,P>0.05。结论来酸麦角新碱联合卡前列素氨丁三醇在宫缩乏力性产后出血防治中具有显著的应用优势,能有效降低产后出血发生率和出血量,减少宫底高度和恶露持续时间,且安全性高。 展开更多
关键词 宫缩乏力 产后出血 马来酸麦角新碱 卡前列素氨丁三醇 子宫复旧
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bFGF通过NF-κB信号通路抑制人子宫平滑肌收缩
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作者 都园渊 朱盛兰 +4 位作者 张慧婷 江一 周璇 丁文成 冯玲 《现代妇产科进展》 2024年第5期357-361,368,共6页
目的:探讨外源性碱性成纤维细胞生长因子(bFGF)对人子宫平滑肌原代细胞(HUt SMCs)收缩功能的影响及其可能机制。方法:用不同浓度外源性bFGF对子宫平滑肌细胞进行干预,qRT-PCR法检测缝隙连接蛋白(CX43)、催产素受体(OXTR)mRNA水平,Wester... 目的:探讨外源性碱性成纤维细胞生长因子(bFGF)对人子宫平滑肌原代细胞(HUt SMCs)收缩功能的影响及其可能机制。方法:用不同浓度外源性bFGF对子宫平滑肌细胞进行干预,qRT-PCR法检测缝隙连接蛋白(CX43)、催产素受体(OXTR)mRNA水平,Western blot法检测CX43、OXTR蛋白表达;胶原收缩实验研究外源性bFGF对HUt SMCs收缩能力的影响;激光共聚焦显微镜观察细胞内Ca 2+水平。用外源性bFGF和JSH-23(NF-κB转录活性抑制剂)处理人子宫平滑肌原代细胞,Western blot法检测CX43和NF-κB p65蛋白表达;酶联免疫吸附实验(ELISA)检测HUt SMCs分泌的IL-6、IL-8水平。结果:bFGF可抑制HUt SMCs收缩相关分子(CX43、OXTR)mRNA和蛋白表达。bFGF可抑制HUt SMCs收缩能力并使细胞内Ca 2+水平降低。bFGF上调人子宫平滑肌细胞NF-κB蛋白表达并下调CX43蛋白表达,促进其分泌IL-8,这种效应被JSH-23所逆转。结论:bFGF通过激活NF-κB通路发挥促炎作用并调控CX43表达,从而参与调节HUt SMCs的收缩能力。 展开更多
关键词 碱性成纤维细胞生长因子 NF-ΚB通路 宫缩乏力 产后出血
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卡前列素氨丁三醇联合宫腔球囊填塞治疗前置胎盘剖宫产产后出血对出血量情况的影响分析
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作者 李秀华 李丙彩 张伟 《系统医学》 2024年第12期145-149,共5页
目的 探究与分析卡前列素氨丁三醇联合宫腔球囊填塞治疗前置胎盘剖宫产产后出血对出血量情况的影响。方法 目的选取2020年3月—2022年8月山东省潍坊市临朐县人民医院收治的80例前置胎盘剖宫产产后出血患者为研究对象并按照治疗方法不同... 目的 探究与分析卡前列素氨丁三醇联合宫腔球囊填塞治疗前置胎盘剖宫产产后出血对出血量情况的影响。方法 目的选取2020年3月—2022年8月山东省潍坊市临朐县人民医院收治的80例前置胎盘剖宫产产后出血患者为研究对象并按照治疗方法不同分为两组,每组40例,对照组采取缩宫素联合卡前列素氨丁三醇治疗,观察组加用宫腔球囊填塞治疗,对比两组临床疗效、手术时间、首次月经时间、白细胞计数、血清C反应蛋白、出血量、住院时间及输血率、子宫切除率。结果 观察组临床总有效率为95.00%,较对照组(77.50%)高,差异有统计学意义(χ^(2)=5.165,P<0.05)。观察组手术时间、首次月经时间、白细胞计数、血清C反应蛋白水平、术中出血量、产后2 h出血量、产后24 h出血量、住院时间均优于对照组,差异有统计学意义(P均<0.05)。结论 卡前列素氨丁三醇联合宫腔球囊填塞治疗前置胎盘剖宫产产后出血可获得更好的临床疗效,围术期指标表现较好,同时可降低输血率以及子宫切除率,可获得更好的预后。 展开更多
关键词 卡前列素氨丁三醇 宫腔球囊填塞 前置胎盘 剖宫产 产后出血
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