目的：探讨难治性产后出血的各种治疗方法的应用价值。方法回顾性分析2006年1月至2012年12月在湖南省妇幼保健院住院，分别采用宫腔塞纱术、经导管动脉栓塞术、子宫动脉结扎术和髂内动脉结扎术、子宫切除术及盆腔塞纱术等方法治疗的86例难治性产后出血产妇的临床资料。结果18例行宫腔塞纱术成功12例（66．7％），29例（100．0％）行经导管动脉栓塞术均获成功，12例行子宫动脉结扎术和髂内动脉结扎术成功9例（75．0％），12例行子宫切除术成功9例（75．0％），15例行盆腔塞纱术成功9例（60．0％）。对宫腔塞纱术、子宫动脉结扎术和髂内动脉结扎术及盆腔塞纱术失败的18例患者行经导管动脉栓塞术成功13例（72．2％）。结论对不同类型的难治性产后出血可采用1种或联合多种止血方式；合理选择治疗方法，把握抢救时机。%Objective To investigate the application value of various treatments for intractable postpartum hemorrhage .Methods A retrospective analysis was conducted on clinical data of 86 cases of intractable postpartum hemorrhage admitted in Maternal and Child Health Hospital of Hunan Province in the period of January 2006 to December 2012.They were treated with uterine plug yarn , transcatheter arterial embolization , uterine artery ligation and iliac artery ligation , hysterectomy or pelvic plug yarn .Results Twelve of 18 cases with uterine plug yarn surgery succeed (66.7%), and all of 29 cases undergoing transcatheter artery embolization were successful (100.0%).Nine of 12 cases (75.0%) underwent uterine artery ligation and iliac artery ligation successfully .There were 9 of 12 cases successfully undergoing hysterectomy (75.0%).Among 15 cases with pelvic plug yarn, 9 were successful (60.0%).There were 18 cases with failure either for uterine yarn plug , uterine artery ligation and internal iliac artery ligation , or pelvic surgery with yarn plug . Among them 13 were successful with the treatment of transcatheter arterial embolization (72.2%).Conclusion According to different types of intractable postpartum hemorrhage , one or more treatment methods can be chosen .Treatment method should be chosen reasonably and opportunity should be taken for rescue .
展开▼
