| 朱雯静,乔春红,李惠卿,梁升连,戚亚兰,方月兰,应小燕.子宫动脉栓塞术与子宫切除术应用于胎盘因素所致严重产后出血产妇中的效果比较[J].,2024,(2):363-367 |
| 子宫动脉栓塞术与子宫切除术应用于胎盘因素所致严重产后出血产妇中的效果比较 |
| Comparison of the Effect of Uterine Artery Embolization and Hysterectomy on Severe Postpartum Hemorrhage Caused by Placental Factors |
| 投稿时间：2023-08-04 修订日期：2023-08-28 |
| DOI：10.13241/j.cnki.pmb.2024.02.031 |
| 中文关键词: 胎盘因素 严重产后出血 子宫动脉栓塞术 子宫切除术 效果 |
| 英文关键词: Placental factors Severe postpartum hemorrhage Uterine artery embolization Hysterectomy Effect |
| 基金项目:江苏省妇幼保健协会科研项目（F202031） |
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| 中文摘要: |
| 摘要 目的：比较子宫动脉栓塞术与子宫切除术应用于胎盘因素所致严重产后出血产妇中的效果。方法：回顾性分析南京鼓楼医院集团宿迁医院和南京医科大学第二附属医院于2014年1月至2021年12月期间收治的86例胎盘因素所致严重产后出血产妇的临床资料，根据手术方式分为子宫切除组（34例）与介入组（52例）；其中子宫切除组采用子宫切除术治疗，介入组采用子宫动脉栓塞术治疗。比较两组止血效果、出血量、围术期相关临床指标（手术时间、术后首次下床活动时间、术后住院时间）、术后并发症发生情况、凝血功能要因子、女性性功能指数量表（FSFI）评分和生活质量评分量表（SF-36）评分。结果：两组出血量、止血有效率比较无差异（P＞0.05）；介入组手术时间、术后首次下床活动时间、术后住院时间均短于子宫切除组（P＜0.05）；两组均无严重并发症发生，在感染、伤口渗血、疼痛、阴道出血及恶心呕吐的发生率无差异（P＞0.05）；其中介入组未见栓塞综合征，且发热发生率低于子宫切除组（P＜0.05）；术后6个月，两组孕妇血清APTT，PT升高，FIB下降，且介入组的FIB短于子宫切除组，PT、APTT高于子宫切除组（P＜0.05）；介入组术后6个月的FSFI评分和SF-36评分均高于子宫切除组（P＜0.05）。结论：子宫动脉栓塞术与子宫切除术应用于胎盘因素所致严重产后出血产妇中的效果相当，前者在促进术后康复、改善凝血功能和提高性生活质量、生活质量上具有优势，值得进一步研究应用。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of uterine artery embolization and hysterectomy in the treatment of severe postpartum hemorrhage caused by placenta factors. Methods: The clinical data of 86 women with severe postpartum hemorrhage due to placental factors admitted to Nanjing Gulou Hospital Group Suqian Hospital and the Second Affiliated Hospital of Nanjing Medical University between January 2014 and December 2021 were retrospectively analyzed and divided into a hysterectomy group (34 cases) and an interventional group (52 cases) according to the procedure; among them, the hysterectomy group was treated with hysterectomy and the interventional group was treated with uterine artery. The hysterectomy group was treated with hysterectomy and the intervention group with uterine artery embolization. The hemostatic effect, bleeding volume, perioperative clinical indicators (operation time, first postoperative bed activity time, postoperative hospitalization time), postoperative complications, coagulation factors, Female Sexual Function Index Scale (FSFI) scores and Quality of Life Scale (SF-36) scores were compared between the two groups. Results: There was no difference in blood loss and hemostatic efficiency between the two groups(P>0.05). The operation time, the first time of getting out of bed after surgery, and the postoperative hospitalization time in the interventional group were shorter than those in the hysterectomy group(P<0.05). No serious complications occurred between the two groups, and there were no differences in the incidence of infection,wound bleeding,pain,vaginal bleeding,nausea and vomiting (P>0.05). There was no embolic syndrome in the interventional group,and the incidence of fever was lower than that in the hysterectomy group (P<0.05). Six months after surgery, serum APT in both groups increased PT and FIB decreased, and FIB was shorter than the hysterectomy group, and PT and APTT were higher than those in the hysterectomy group (P<0.05). The FSFI scores and SF-36 scores of the interventional group were higher than those of the hysterectomy group 6 months after surgery (P<0.05). Conclusion: The effect of uterine artery embolization is similar to that of hysterectomy in the treatment of severe postpartum hemorrhage caused by placenta factors, the former has advantages in promoting postoperative rehabilitation, protecting ovarian reserve function and improving life quality and quality of life, which is worthy of further study and application. |
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