血管介入治疗技术用于胎盘植入致产后大出血患者的临床疗效分析-现代医学

血管介入治疗技术用于胎盘植入致产后大出血患者的临床疗效分析

单位：广东医科大学附属医院介入病区, 广东湛江 524001

分类号：R714.46

出版年·卷·期（页码）：2018·46·第六期（678-682）

摘要：

目的：探讨血管介入治疗技术用于胎盘植入致产后大出血患者的临床疗效。方法：选择2015年3月至2017年3月我院接诊的90例胎盘植入致产后大出血的产妇进行研究，通过随机数字表法分为观察组（n=45）和对照组（n=45），对照组给予B-Lynch缝合术治疗，观察组给予血管介入技术治疗，比较两组术中出血量、术后出血量、住院时间、并发症、恶露时间、术后月经及雌激素情况。结果：观察组术中出血量、术后出血量明显少于对照组[（189.32±24.39）ml vs（276.34±31.20）ml，（76.53±11.35）ml vs（99.78±13.47）ml]，住院时间明显比对照组短[（9.45±1.87）d vs（13.94±2.30）d]，差异均具有统计学意义（均P<0.05）；两组术后宫腔粘连、宫腔感染、恶心呕吐、下肢麻木发生率比较差异无统计学意义（P>0.05）；两组恶露时间、首次月经量比较差异无统计学意义（P>0.05），但观察组首次月经恢复时间明显短于对照组[（112.71±14.20）d vs（128.34±16.32）d]，差异具有统计学意义（P<0.05）；两组首次月经期卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E₂）均在正常范围内，且两组FSH、LH、E₂比较差异无统计学意义（P>0.05）。结论：在胎盘植入所致的产后大出血患者中使用血管介入技术止血效果令人满意，可缩短住院时间及月经恢复时间，且不对卵巢功能恢复产生影响，临床应用价值高。

Objective:To study the clinical efficacy of vascular interventional therapy in patients with postpartum hemorrhage caused by placenta implantation. Methods:90 patients of postpartum hemorrhage caused by placental implantation who received therapy from March 2015 to March 2017 in our hospital were selected as research objects, according to random number table,those patients were divided into the observation group (n=45) and the control group (n=45), the control group was treated with B-Lynch suture technique, while the observation group was treated with vascular interventional technique. The intraoperative bleeding, postoperative bleeding, hospitalization time, complications, postoperative lochia time, menstruation and estrogens of two groups were compared. Results:The intraoperative bleeding, postoperative bleeding in the observation group were significantly less than those of the control group[(189.32±24.39)ml vs(276.34±31.20)ml,(76.53±11.35)ml vs(99.78±13.47)ml], and the hospitalization time was significantly shorter than that of the control group[(9.45±1.87)d vs(13.94±2.30)d], the difference was statistically significant(all P<0.05). There was no significant difference in the incidence of intrauterine adhesions, uterine cavity infection, nausea and vomiting, and lower extremity numbness in the two groups(P>0.05). There was no significant difference in the lochia time and first period of menstruation(P>0.05), but the first menstrual recovery time in the observation group was significantly shorter than that of the control group[(112.71±14.20)d vs(128.34±16.32)d], the difference was statistically significant(P<0.05). In the two groups, the follicular stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E₂) were in the normal range for the first period of menstrual period, and there was no significant difference between the two groups(P>0.05).Conclusion:The hemostatic effect of vascular interventional technique is satisfactory in patients with postpartum hemorrhage caused by placental implantation, which can shorten the time of hospitalization and menstrual recovery, and do not affect the ovarian function recovery, and the clinical value is high.

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