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目的探讨产后大出血发病因素及采用动脉栓塞治疗的效果。方法选择2012~2013年西电集团医院与陕西省人民医院收治的320例产妇的临床资料,其中采用栓塞治疗的产后大出血产妇120例,产科分娩、未发生产后大出血的产妇200例为对照,分析产后大出血的发病因素及栓塞治疗的预后情况。结果 120例产后大出血产妇中,58例为阴道动脉出血,42例为子宫动脉出血,20例为阴部内动脉出血。不同动脉出血产妇的止血成功率、栓塞时间、输血量与住院时间比较差异均无统计学意义(P>0.05)。Logistic回归模型结果显示新生儿体重、孕次≥3次、二次剖宫产、胎盘前置、胎盘植入、子宫收缩乏力、是产后大出血的主要危险因素(P<0.05)。结论影响产后大出血的因素是多样化的,应积极进行综合预防。产后大出血产妇选择动脉栓塞治疗具有手术时间短、恢复快、效果肯定且可保留子宫等优点。
Objective To investigate the incidence of postpartum hemorrhage and the use of arterial embolization. Methods The clinical data of 320 maternal women treated by Xidian Group Hospital and Shaanxi Provincial People’s Hospital from 2012 to 2013 were retrospectively analyzed. Among them, 120 maternal postpartum hemorrhage patients were treated by embolization, and 200 maternal obstetric labor and no postpartum hemorrhage were used as controls The incidence of postpartum hemorrhage and embolization of the prognosis of the situation. Results 120 cases of postpartum hemorrhage maternal, 58 cases of vaginal bleeding, 42 cases of uterine artery bleeding, 20 cases of intra-genital bleeding. The success rate of hemostasis, embolization time, blood transfusion and length of hospital stay in different arterial bleeding women were not statistically significant (P> 0.05). The results of Logistic regression model showed that the birth weight, number of pregnancies ≥ 3 times, secondary cesarean section, placenta previa, placenta accreta and uterine atony were the main risk factors of postpartum hemorrhage (P <0.05). Conclusion The factors affecting postpartum hemorrhage are diversified, and comprehensive prevention should be actively carried out. Postpartum hemorrhage maternal choice of arterial embolization has the advantages of short operative time, rapid recovery, the effect is positive and can retain the uterus.