子宫动脉结扎与栓塞对剖宫产术后子宫乏力性产后出血的影响及其对子宫和卵巢动脉血流和功能的影响。
Effect of Uterine Artery Ligation and Uterine Artery Embolization on Postpartum Hemorrhage Due to Uterine Asthenia after Cesarean Section and Its Effect on Blood Flow and Function of Uterine and Ovarian Arteries.
机构信息
Obstetrics and Reproductive Center, Affiliated Hospital of Yunnan University, Kunming 650021, China.
出版信息
J Healthc Eng. 2022 Mar 21;2022:1337234. doi: 10.1155/2022/1337234. eCollection 2022.
OBJECTIVE
To investigate the efficacy of uterine artery ligation (UAL) and uterine artery embolization (UAE) in the treatment of uterine asthenia postpartum hemorrhage (PPH) after cesarean section and its effect on uterine and ovarian artery blood flow and function.
METHODS
100 patients with uterine asthenia PPH after cesarean section in our hospital from January 2018 to November 2020 were randomly divided into 50 cases in the UAL group and 50 cases in the UAE group. They were followed up for 12 months. The bleeding volume, operation time, immediate hemostasis rate, and hemostasis effective rate; lochia clearance time and menstrual rehydration time; RI and S/D; and serum FSH, E2, and LH levels were compared between the two groups.
RESULTS
Compared with the UAL group, the amount of bleeding in the UAE group was significantly increased and the operation time was significantly shortened ( < 0.05). There was no significant difference in the immediate hemostatic rate and hemostatic effective rate between the two groups ( > 0.05). There was no significant difference in lochia clearance time and menstrual rehydration time between the two groups ( > 0.05). There was no significant difference in RI and S/D between the two groups ( > 0.05). Compared with before the operation, the levels of FSH and LH in the two groups decreased significantly, and the level of E2 increased significantly ( < 0.05). There was no significant difference between the two groups ( > 0.05).
CONCLUSION
The efficacy of UAL and UAE in the treatment of PPH with uterine asthenia after cesarean section and its effect on the blood flow and function of uterine and ovarian arteries are equivalent, but the amount of bleeding in UAL is less and the operation time of UAE is shorter. The appropriate operation method can be selected according to the actual situation.
目的
探讨子宫动脉结扎术（Uterine Artery Ligation，UAL）和子宫动脉栓塞术（Uterine Artery Embolization，UAE）治疗剖宫产术后子宫乏力性产后出血（Postpartum Hemorrhage，PPH）的疗效及其对子宫和卵巢动脉血流和功能的影响。
方法
选取我院 2018 年 1 月至 2020 年 11 月收治的 100 例剖宫产术后子宫乏力性 PPH 患者，随机分为 UAL 组和 UAE 组各 50 例，随访 12 个月。比较两组患者的出血量、手术时间、即刻止血率、止血有效率；恶露排出时间和月经复潮时间；RI 和 S/D；以及血清 FSH、E2 和 LH 水平。
结果
与 UAL 组相比，UAE 组出血量明显增加，手术时间明显缩短（<0.05）。两组即刻止血率和止血有效率比较差异无统计学意义（>0.05）。两组恶露排出时间和月经复潮时间比较差异无统计学意义（>0.05）。两组 RI 和 S/D 比较差异无统计学意义（>0.05）。与术前相比，两组 FSH 和 LH 水平均明显下降，E2 水平明显升高（<0.05）。两组间比较差异无统计学意义（>0.05）。
结论
子宫动脉结扎术和子宫动脉栓塞术治疗剖宫产术后子宫乏力性产后出血的疗效相当，但子宫动脉结扎术出血量较少，子宫动脉栓塞术手术时间较短。可根据实际情况选择合适的手术方法。
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