选择性子宫动脉栓塞术对难治性产后出血的应用效果研究

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　　[摘要] 目的 研究分析难治性产后出血患者采用选择性子宫动脉栓塞术治疗的临床效果。方法 该院于2016年5月—2018年5月方便选取的46例难治性产后出血患者作为该次研究的对象，采用数字表法随机分组原则，分为参照组和研究组，参照组有23例，予以子宫切除术治疗，研究组有23例，予以选择性子宫动脉栓塞术治疗，对研究组与参照组的临床疗效、治疗后并发症进行比较。 结果 研究组总有效率为95.65%，与参照组总有效率69.57%比较差异有统计学意义（χ2=5.447 4，P=0.019 6）；研究组手术时间、出血量以及止血时间、术后下床活动时间、住院天数，均与参照组比较差异有统计学意义（t=65.686 2、20.981 7、8.760 6、11.813 5、12.614 6，P=0.000 0、0.000 0、0.000 0、0.000 0、0.000 0）；研究组手术并发症发生率为17.39%，与参照组手术并发症发生率26.08%比较差异无统计学意义（χ2=0.5111，P=0.474 7）。 结论 难治性产后出血患者配合选择性子宫动脉栓塞术，其临床疗效更加确切，值得推广。
　　[关键词] 难治性产后出血；选择性子宫动脉栓塞术；子宫切除术；临床治疗效果
　　[中图分类号] R714.46+1 [文献标识码] A [文章编号] 1674-0742（2019）02（b）-0077-03
　　Effect of Selective Uterine Artery Embolization on Refractory Postpartum Hemorrhage
　　HE Jia-jia
　　Department of Obstetrics and Gynecology， Dianjiang County People's Hospital， Chongqing， 408300 China
　　[Abstract] Objective To analyze the clinical effects of selective uterine artery embolization in patients with refractory postpartum hemorrhage. Methods 46 patients with refractory postpartum hemorrhage convenient selected from May 2016 to May 2018 in our hospital were randomly divided into reference group and study group by the digital group method. 23 patients underwent hysterectomy， and 23 patients in the study group were treated with selective uterine artery embolization. The clinical efficacy and post-treatment complications of the study group and the reference group were compared. Results The total effective rate of the study group was 95.65%， which was different from the total effective rate of the reference group （69.57%） （χ2=5.447 4， P=0.019 6）. The operation time， the amount of bleeding and the time of hemostasis， and the time to get out of the study group， the time of activity and the number of hospital stays were different from those of the reference group（t=65.686 2， 20.981 7， 8.760 6， 11.813 5， 12.614 6， P=0.000 0， 0.000 0， 0.000 0， 0.000 0， 0.000 0）； the incidence of surgical complications in the study group was 17.39%. There was no significant difference between the incidence of surgical complications and the reference group （26.08%）， which was not statistically significant （χ2=0.511 1， P=0.474 7）. Conclusion Patients with refractory postpartum hemorrhage combined with selective uterine artery embolization have a more precise clinical effect and are worthy of promotion.
　　[Key words] Refractory postpartum hemorrhage； Selective uterine artery embolization； Hysterectomy； Clinical treatment effect
　　對目前临床中针对难治性产后出血患者治疗相关研究课题进行翻阅查找，发现相较于子宫切除术治疗，选择性子宫动脉栓塞术治疗的效果更加优异，能够在提升患者止血成功率的情况下，最大程度的保留患者生育功能[1]。在此研究环境下，该院方便选择2016年5月—2018年5月收治的对46例患者，对选择性子宫动脉栓塞术治疗难治性产后出血患者效果进行分析，报道如下。
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