子宫动脉栓塞术对产后出血患者并发症及再次妊娠围生期妊娠结局的影响

目的 探讨子宫动脉栓塞术（UAE）对产后出血（PPH）患者并发症及再次妊娠围生期妊娠结局的影响。方法 选择2015年1月至2019年12月唐山市妇幼保健院妇接收的79例UAE治疗的PPH患者作为UAE组，选择同期在我院接受子宫动脉结扎术（UAL）治疗的78例PPH患者作为UAL组。比较两组术中及术后恢复情况、卵巢功能指标水平、术后近远期并发症发生率及再次妊娠围生期妊娠结局。通过logistic回归分析确定产后出血治疗后远期并发症发生的影响因素。结果 UAE组术中失血量[（959.70±203.15）mL]、止血时间[（30.59±5.81）min]、住院时间[（7.33±1.58）d]、产后月经恢复时间[（72.14±16.42）d]均少于UAL组，产后首次月经量/妊娠前平均月经量（1.13±0.35）多于UAL组，差异均有统计学意义（P<0.05）;UAL组术后抗缪勒氏管激素（AMH）、雌二醇（E2）水平较术前降低（P<0.05），卵泡刺激素（FSH）水平较术前增高（P<0.05），两组术前后AMH、E2、FSH的差值比较，差异有统计学意义（P<0.05）;U...

Effect of uterine artery embolization on complications of postpartum bleeding patients and perinatal pregnancy outcome of second pregnancy

Objective To explore the effect of uterine artery embolization (UAE) on the complications of postpartum bleeding (PPH) and perinatal pregnancy outcome of second pregnancy. Methods From January 2015 to December 2019, 79 patients with PPH who received UAE treatment in Tangshan Maternal and Child Health Hospital were regarded as the UAE group, and 78 patients with PPH who received uterine artery ligation (UAL) treatment in our hospital were regarded as the UAL group. The intraoperative and postoperative recovery, the levels of ovarian function, the incidence of short-and long-term postoperative complications, and the pregnancy outcome of re-pregnancy were compared between the two groups. At the same time, the influencing factors of long-term complications after treatment of postpartum hemorrhage were determined by logistic regression analysis.Results The intraoperative blood loss[(959.70±203.15) mL], hemostasis time [(30.59±5.81) min],hospital stay[(7.33±1.58) d], and postpartum menstrual recovery time[(72.14±16.42) d] in the UAE group were obviously lower than those in the UAL group[(1 206.41±226.84) mL, (45.24±7.56) min,(9.56±2.27) d,(77.73±18.02) d](P<0.05),and the ratio of first postpartum menstrual volume to average menstrual volume before pregnancy (1.13±0.35) were obviously higher than those in the UAL group(0.92±0.29)(P<0.05),after operation, the level of AMH and E2 in the UAL group were lower than that before operation(P<0.05),the levels of FSH in the UAL group was higher than that before operation(P<0.05),and the difference in AMH, E2, and FSH between the two groups before and after surgery was statistically significant(P<0.05),the short-term and long-term complication rate of the UAE group was 3.80% and 5.06%, respectively, which was ob viously lower than that of the UAL group(12.82% and 15.38%)(P<0.05),and logistic regression analysis confirmed that the treatment method was the factor affecting the occurrence of long-term complications after the treatment of postpartum hemorrhage, there was no obvious difference in the incidence of perinatal pregnancy outcomes such as scar pregnancy,spontaneous abortion and placenta previa in the UAE group compared with the UAL group (P>0.05). Conclusions Compared with UAL,UAE has more rapid hemostasis in PPH patients, shorter menstrual recovery time,less impact on ovarian function, and lower incidence of near-and long-term complications.There was no difference in perinatal pregnancy outcome between the two hemostatic methods.