子宫动脉栓塞术治疗难治性妇产科大出血的疗效观察

摘要

Objective To observe curative effect by uterine arterial embolization in the treatment of refractory gynecological massive hemorrhage.Methods A total of 56 patients with refractory gynecological massive hemorrhage were randomly divided into observation group and control group, with 28 cases in each group. The observation group received uterine arterial embolization, and the control group received uterine artery ligation. Comparison was made on surgical and postoperative condition between the two groups.Results The observation group had all better intraoperative bleeding volume as (768.5±46.8) ml, operation time as (45.23±6.90) min, hysterectomy rate as 7.1% and effective hemostasis rate as 92.9% than (1134.4±95.1) ml, (78.70±10.20) min, 46.4% and 53.6% in the control group (P<0.05). There was no statistically significant difference of maximal body temperature [(38.2±0.8)℃ VS (38.6±0.7)℃], abdominal discomfort [42.9% VS 39.3%], pain [50.0% VS 46.4%], and colporrhagia time [(9.6±3.1) d VS (11.4±6.5) d] between the two groups (P>0.05).Conclusion Uterine arterial embolization provides definite curative effect in treating refractory gynecological massive hemorrhage, along with stable postoperative status in patients and no severe complications. It is an effective and safe treatment method which is worth promoting.%目的：观察子宫动脉栓塞术治疗难治性妇产科大出血的疗效。方法56例难治性妇产科大出血患者，随机分为观察组与对照组，各28例。观察组行子宫动脉栓塞术，对照组行子宫动脉结扎术。比较两组的手术情况及术后情况。结果手术情况：观察组术中出血量(768.5±46.8)ml、手术时间(45.23±6.90)min、子宫切除率7.1%、止血有效率92.9%均优于对照组的(1134.4±95.1)ml、(78.70±10.20)min、46.4%、53.6%(P<0.05)。术后情况：两组最高体温[(38.2±0.8)℃ VS (38.6±0.7)℃]、腹部不适[42.9% VS 39.3%]、疼痛[50.0% VS 46.4%]、阴道出血时间[(9.6±3.1)d VS (11.4±6.5)d]比较差异均无统计学意义(P>0.05)。结论子宫动脉栓塞术在治疗难治性妇产科大出血方面疗效肯定，且患者术后情况稳定，未见严重并发症，是较为有效、安全的一种治疗技术，值得推广。