不同止血手术在难治性产后出血患者中的疗效对比观察

王芳

（陕西省宝鸡眉县人民医院妇产科，陕西宝鸡，苑圆圆猿园园）

浏览次数：92次 下载次数：433次

摘要：

目的 观察不同止血手术在难治性产后出血患者中的临床治疗效果。方法 选取2014年1月至2016年6月我院诊治的难治性产后出血60例，根据不同手术方式分为对照组（n=30）和治疗组（n=30）。对照组采用盆腔血管结扎治疗，治疗组采用盆腔动脉栓塞手术治疗，比较两组临床疗效。结果 治疗组患者手术时间、术中出血量及总输血量显著优于对照组（P<0.05）；治疗组患者宫缩乏力、前置胎盘及胎盘植入止血成功率显著高于对照组（P<0.05）；治疗组治疗后躯体、角色、社会及认知评分高于对照组（P<0.05）。结论 与盆腔血管结扎治疗相比，难治性产后出血患者采用盆腔动脉栓塞手术治疗效果理想，值得推广。

关键词：不同止血手术；难治性产后出血；成功率

中图分类号：R714.461文献标志码：A文章编号：2096-1413(2017)07-0090-02

Comparative observation of the curative effects of different hemostasis in the treatment of patients with intractable postpartum hemorrhage

WANG Fang

(Obstetrics and Gynecology Department, People's Hospital of Mei County, Baoji 722300, China)

ABSTRACT: Objective To investigate the clinical effects of different hemostasis in the treatment of patients with intractable postpartum hemorrhage. Methods From January 2014 to June 2016, 60 cases of postpartum hemorrhage in patients with refractory in our hospital were selected, and divided into control group (n=30) and treatment group (n=30) according to the different surgical methods. The control group received pelvic vessel ligation treatment, the treatment group received pelvic arterial embolization treatment, the clinical efficacy of the two groups was compared. Results After the treatment, the surgical operation time, blood loss and total amount of blood transfusion in the treatment group were significantly better than those in the control group (P<0.05); the uterine inertia, placenta previa and placenta accreta hemostasis success rate of the treatment group were significant higher than those of the control group (P<0.05). After the nursing, the score of body, role, social and cognitive in the treatment group were significant higher than those of the control B group (P<0.05). Conclusion Refractory pelvic arterial embolization surgery in the treatment of postpartum hemorrhage has significant effect, which should be widely applied.

KEYWORDS: different surgery to stop bleeding; intractable postpartum hemorrhage; success rate

参考文献：
[1] 林卫琼,李大严.五种止血手术治疗难治性产后出血的效果比较及止血失败的原因分析[J].中国医药,2014,9(3):385-387.
[2] 王淑婷,赵妍,王谢桐.子宫压迫缝合术治疗产后出血的临床应用进展[J].中华围产医学杂志,2013,16(8):457-460
[3] 巩学业,张文娟,齐丽丽.预防产后出血两种干预措施的临床研究[J].中华全科医师杂志,2013,12(10):835-836.
[4] 罗方媛,陈锰,张力,等.难治性产后出血的五种止血手术疗效的比较及止血失败原因分析[J].中华妇产科杂志,2012,47(9):641-645.
[5] 刘书花,王健,焦清海,等.介入栓塞治疗对产后出血患者卵巢功能的影响[J].中华急诊医学杂志,2013,22(10):1172-1174.
[6] 范丽,高霞,马亚琳.卡前列素氨丁三醇联合低位BLynch 缝合术治疗难治性前置胎盘性产后出血的临床分析[J].中华妇幼临床医学杂
志:电子版,2013,9(2):177-179.
[7] KAOIEAN S.Successful use of the B-Lynch uterine compression su-ture in treating intractable postpartum hemorrhage after cesarean deliv-ery in rajavithi hospital[J].J Med Assoc Thai,2013,96(11):1408-1415.
[8] YAMASAKI Y,MORITA H,MIYAHARA Y,et al.The factors associ-ated with the failure of transcatheter pelvic arterial embolization for in-tra ctable postpartum hemorrhage[J].J Perinat Med,2014,42(3):359-362.
[9] 林卫琼,李大严.五种止血手术治疗难治性产后出血的效果比较及止血失败的原因分析[J].中国医药,2014,9(3):385-387.
[10] WADA N,TACHIBANA D,NAKAGAWA K,et al.Pathological find-ings in a case of failed uterine artery embolization for placenta previa[J].Jpn Clin Med,2013,4(4):25-28.
[11] 温弘,陈璐,贺晶,等.剖宫产术后子宫假性动脉瘤致晚期产后出血一例报告并文献复习[J].中华妇产科杂志,2014,49(9):694-696.
[12] PARK HS,SHIN JH,YOON HK,et al.Transcatheter arterial em-bolization for secondary postpartum hemorrhage: outcome in 52 patients at a single tertiary referral center[J].J Vascul Interven Radiol,2014,25(11):1751-1757.