摘要
目的:探讨影响子宫动脉栓塞治疗产后出血的疗效的因素。方法:回顾了武汉大学中南医院2010年1月至2016年12月对产后出血行子宫动脉栓塞治疗的62例病例的临床资料,行子宫动脉栓塞术治疗有效组49例,无效组13例,用多因素分析法比较了两组一般情况、孕产史、产科合并症以及其他因素对疗效的影响,提出可能导致子宫动脉栓塞治疗产后出血效果不佳的预测因素。结果:62例病例中,子宫动脉栓塞治疗产后出血无效者13例(21%)。不同于以往文献报道,发现胎盘因素(包括胎盘植入和胎盘粘连)是导致产后出血的主要因素。无效组中休克指数及DIC指数明显高于有效组。结论:胎盘粘连是我院产后大出血的主要原因,当产后出血量超过1 500mL预示着子宫动脉栓塞术治疗产后出血效果不佳。对于有持续出血的病人在生命体征稳定、出现血流动力学改变之前,子宫动脉栓塞可以被直接启用。
Objective:To identify the predictive factors of a poor response to uterine arterial embolization(UAE)for the treatment postpartum hemorrhage(PPH).Methods:This is a retrospective cohort study which included 62 cases of PPH treated by UAE in our hospital from January 2010 to September 2016.Medical and obstetric history,clinical elements and other biological parameters were compared in good-response group(49 cases)versus poor-response group(13 cases).Univariate analysis was performed to determine the factors related to poor response to UAE for treatment of PPH.Results:UAE failed in 13 cases(21.0%).Our study showed that placental factors(including placenta accreta and placenta previa)were the most common causes for PPH.Shock index and total obstetrical DIC scores were higher in the poor-response group than in the good-response group.Conclusion:Placental factors are the main cause of postpartum hemorrhage in our hospital.When the postpartum hemorrhage exceeds 1 500 mL,it indicates failed PAE.Uterine artery embolization can be directly activated in patients with persistent bleeding before vital signs are stabilized and hemodynamic changes occur.
作者
罗丽丽
甘莉娟
蔡红兵
LUO Lili;GAN Lijuan;CAI Hongbing(Dept.of Obstetrics and Gynecology,Henan Pingdingshan City Xinhua District People's Hospital,Pingdingshan 467000,Henan,China;Dept.of Gynecology Oncology,Zhongnan Hospital of Wuhan University,Hubei Cancer Clinical Study Center,&Hubei Key Laboratory of Tumor Biological Behaviors,Wuhan 430071,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2019年第4期650-653,共4页
Medical Journal of Wuhan University
关键词
子宫动脉栓塞
产后出血
预测因素
Uterine Artery Embolization
Postpartum Hemorrhage
Predictive Factors
