摘要
目的探讨影响产后大出血患者子宫动脉栓塞术疗效的危险因素。方法选择2016年1月至2018年6月佛山市禅城区中心医院诊治的143例难治性产后出血患者为研究对象,所有患者均采用子宫动脉栓塞术治疗,根据术后是否出现2次出血将患者分为成功组和失败组,其中成功组有125例患者,失败组有18例患者。统计分析影响治疗效果的潜在危险因素。结果子宫动脉栓塞术治疗难治性产后出血的成功率为87.4%。失败组患者的妊娠期合并症、瘢痕子宫史、软产道损伤、胎盘因素、凝血功能障碍和宫缩乏力共6个因素与成功组患者相比,其差异均具有统计学意义(P<0.05)。多变量Logistic回归分析结果显示,瘢痕子宫史、软产道损伤、胎盘因素、凝血功能障碍和宫缩乏力共5个因素为影响产后出血患者子宫动脉栓塞术疗效的危险因素(P<0.05)。结论虽然子宫动脉栓塞术治疗难治性产后出血的成功率较高,但瘢痕子宫史、软产道损伤、胎盘因素、凝血功能障碍和宫缩乏力仍然是产后出血的危险因素。
Objective To investigate the risk factors affecting the efficacy of uterine artery embolization in patients with postpartum hemorrhage. Methods From January 2016 to June 2018, 143 patients with refractory postpartum hemorrhage admitted to our hospital were selected for study. All the patients were treated with uterine artery embolization and were divided into successful group(n=125) and failed group(n=18) according to whether there was secondary bleeding after surgery. Potential risk factors affecting treatment efficiency were analyzed. Results The success rate of uterine artery embolization for refractory postpartum hemorrhage was 87.4%. Six factors(the complications of pregnancy, history of scarred uterus, soft birth canal injury, placental factors, coagulation dysfunction and uterine inertia) in failed group were significantly different from those in successful group(P<0.05). Multivariate logistic regression analysis showed that five factors including scar uterine history, soft birth canal injury, placental factors, coagulopathy and uterine atony were the risk factors for the efficiency of uterine artery embolization in postpartum hemorrhage patients(P<0.05). Conclusions Although uterine artery embolization is associated with a higher success rate for refractory postpartum hemorrhage, scar uterine history, soft birth canal injury, placental factors, coagulopathy, and uterine atony are still risk factors for postpartum hemorrhage.
作者
吴志丽
黄秀英
关珊珊
劳力
杨仪心
WU Zhili;HUANG Xiuying;GUAN Shanshan;LAO Li;YANG Yixin(Department of Gynecology and Obstetrics,Chancheng Central Hospital of Foshan City,Foshan 528042,Guangdong,China)
出处
《中国性科学》
2020年第3期89-92,共4页
Chinese Journal of Human Sexuality
