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目的:探索超选择性子宫动脉栓塞及联合侧支动脉栓塞控制产后出血的治疗效果。方法:143例产后出血患者随机分成2组,A组单纯行超选择性子宫动脉栓塞;B组行超选择性子宫动脉栓塞后经髂外动脉造影发现有侧支动脉,再行侧支动脉栓塞,比较两组手术时间、术后血压、心率。结果:A组89例患者中有2例手术失败,手术成功率为97.75%,B组54例患者,无手术失败,手术成功率为100.00%。A组手术时间(46.91±7.86)min,B组(58.55±8.19)min,A组手术时间明显短于B组(t=-0.448,P<0.001),A组术后血压(116.30±12.75)/(72.57±6.19)mmHg,术后心率(90.23±11.65)次/min,与B组(118.31±11.37)/(76.25±5.97)mmHg,(88.38±10.71)次/min相比较,差异无统计学意义(t=0.129,P=0.897;t=1.606,P=0.111)。结论:超选择性子宫动脉联合侧支动脉栓塞可以有效控制产后出血,提高手术成功率。
Objective: To explore the treatment effect of super selective uterine artery embolization combined with collateral artery embolization in controlling postpartum hemorrhage. Methods: 143 patients with postpartum hemorrhage were randomly divided into 2 groups: group A was treated with superselective uterine arterial embolization alone; group B was treated with superselective uterine artery embolization with collateral artery after external iliac artery angiography; The operation time, postoperative blood pressure and heart rate were compared between the two groups. Results: Two of the 89 patients in group A failed surgery, the success rate was 97.75%. In group B, 54 patients were without operation failure. The successful rate was 100.00%. The operation time of group A was significantly shorter than that of group B (t = -0.448, P <0.001), and the postoperative blood pressure of group A was 116.30 ± 12.75 (46.91 ± 7.86) min and 58.55 ± 8.19 min / (72.57 ± 6.19) mmHg, postoperative heart rate (90.23 ± 11.65) times / min, no significant difference compared with those in group B (118.31 ± 11.37) / (76.25 ± 5.97) mmHg and (88.38 ± 10.71) Significance (t = 0.129, P = 0.897; t = 1.606, P = 0.111). Conclusion: Superselective uterine artery combined with collateral artery embolization can effectively control postpartum hemorrhage and improve the success rate of operation.