Comparison of the Effect of Uterine Artery Embolization and Hysterectomy on Severe Postpartum Hemorrhage Caused by Placental Factors
Objective:To compare the efficacy of uterine artery embolization and hysterectomy in the treatment of severe postpar-tum hemorrhage caused by placenta factors.Methods:The clinical data of 86 women with severe postpartum hemorrhage due to placen-tal factors admitted to Nanjing Gulou Hospital Group Suqian Hospital and the Second Affiliated Hospital of Nanjing Medical University between January 2014 and December 2021 were retrospectively analyzed and divided into a hysterectomy group(34 cases)and an inter-ventional group(52 cases)according to the procedure;among them,the hysterectomy group was treated with hysterectomy and the inter-ventional group was treated with uterine artery.The hysterectomy group was treated with hysterectomy and the intervention group with uterine artery embolization.The hemostatic effect,bleeding volume,perioperative clinical indicators(operation time,first postoperative bed activity time,postoperative hospitalization time),postoperative complications,coagulation factors,Female Sexual Function Index Scale(FSFI)scores and Quality of Life Scale(SF-36)scores were compared between the two groups.Results:There was no difference in blood loss and hemostatic efficiency between the two groups(P＞0.05).The operation time,the first time of getting out of bed after surgery,and the postoperative hospitalization time in the interventional group were shorter than those in the hysterectomy group(P＜0.05).No serious complications occurred between the two groups,and there were no differences in the incidence of infection,wound bleeding,pain,vaginal bleeding,nausea and vomiting(P＞0.05).There was no embolic syndrome in the interventional group,and the incidence of fever was lower than that in the hysterectomy group(P＜0.05).Six months after surgery,serum APT in both groups increased PT and FIB decreased,and FIB was shorter than the hysterectomy group,and PT and APTT were higher than those in the hysterectomy group(P＜0.05).The FSFI scores and SF-36 scores of the interventional group were higher than those of the hysterectomy group 6 months after surgery(P＜0.05).Conclusion:The effect of uterine artery embolization is similar to that of hysterectomy in the treatment of severe post-partum hemorrhage caused by placenta factors,the former has advantages in promoting postoperative rehabilitation,protecting ovarian reserve function and improving life quality and quality of life,which is worthy of further study and application.
NETL
NSTL
万方数据
维普
