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目的:观察不同方法在难治性妇产科大出血治疗效果。方法:将92例难治性妇产科大出血分为治疗组和对照组各46例,对照组采用打开腹腔结扎动脉术,治疗组行经导管动脉栓塞术,采用改良的seldinger法对股动脉进行穿刺。结果:治疗组46例中,有效44例,总有效率为95.7%;对照组46例中,有效39例,总有效率为84.5%。治疗组疗效优于对照组,差异有统计学意义(P<0.05);治疗组止血时间、2 h及24 h出血量均优于对照组(P<0.05);两组手术时间、子宫保留率、术后阴道流血天数比较,治疗组均优于对照组,差异有统计学意义(P<0.05)。而体温比较,两组差异无统计学意义(P>0.05);治疗并发症的发生率也优于对照组。结论:采用的经导管动脉栓塞术使用了经改良的seldinger法对股动脉进行穿刺,研究发现该法相对传统的动脉结扎术有多方面的优点,能减少患者的止血时间,降低子宫的切除率,减轻患者的痛苦。
Objective: To observe the effect of different methods in the treatment of refractory obstetrics and gynecology major hemorrhage. Methods: Ninety-two patients with refractory obstetrics and gynecology were randomly divided into treatment group (46 cases) and control group (46 cases). The control group was treated by open ligation of celiac artery. The treatment group was treated by catheter embolization and the seldinger method was used to puncture the femoral artery . Results: Among the 46 cases in the treatment group, 44 cases were effective and the total effective rate was 95.7%. Among the 46 cases in the control group, 39 cases were effective and the total effective rate was 84.5%. The curative effect of the treatment group was better than that of the control group (P <0.05); the bleeding time of the treatment group was better than that of the control group at 2 h and 24 h (P <0.05); The operation time, , Vaginal bleeding days after treatment, the treatment group were better than the control group, the difference was statistically significant (P <0.05). The body temperature, the difference between the two groups was not statistically significant (P> 0.05); the incidence of complications was better than the control group. Conclusion: The transcatheter arterial embolization using the modified seldinger method to puncture the femoral artery, the study found that the relative advantages of traditional arterial ligation have many advantages, can reduce the patient’s bleeding time and reduce the rate of uterine resection , Reduce the suffering of patients.