摘要
目的:探究子宫动脉栓塞术治疗前置胎盘剖宫产后产后出血对患者应激反应和卵巢储备功能的影响。方法:回顾性分析本院2019年1月-2020年5月收治的前置胎盘剖宫产产后出血产妇60例相关资料,根据治疗方案分为子宫动脉栓塞术组(n=30)和子宫动脉结扎组(n=30)。观察两组止血效果,比较两组术前3d和术后7d时血清醛固酮(ALD)、促肾上腺皮质激素(ACTH)及皮质醇(Cor)应激反应因子水平,术后3、6个月时抗苗勒管激素(AMH)、促卵泡生成素(FSH)、促黄体生成素(LH)及雌二醇(E2)卵巢储备功能指标。结果:栓塞术组和结扎组即刻止血率分别为86.7%和80.0%,止血有效率分别为96.7%和90.0%,两组无差异(P>0.05)。两组术后ALD、ACTH、Cor水平均高于术前但栓塞术组低于结扎术组(P<0.05)。AMH、FSH、LH、E2水平,术后3个月栓塞术组均高于结扎术组(P<0.05),术后6个月两组无差异(P>0.05)。结论:子宫动脉栓塞术用于前置胎盘产妇剖宫产产后出血疗效确切,可更有效降低产妇应激反应,对患者术后短期卵巢储备功能影响程度更小。
Objective:To explore the effects of the surgery of uterine artery embolization for treating patients with postpartum hemorrhage because of placenta previa after cesarean section on their stress response and ovarian reserve function.Methods:The related data of 60 patients with postpartum hemorrhage because of placenta previa after cesarean section from January 2019 to May 2020 were analyzed retrospectively.According to the therapeutic schedule,these patients were divided into group A(30 patients accepted uterine artery embolization)and group B(30 patients accepted uterine artery ligation).The hemostatic effects of the patients in the two groups were observed.The levels of serum aldosterone(ALD),adrenocorticotrophic hormone(ACTH),and cortisol stress response factor of the patients 3d before operation and 7d after operation,and the levels of ovarian reserve function indexes,such as anti-Mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2),of the patients at in and 6 months after operation were compared between the two groups.Results:There were no significant differences in the immediate hemostatic rate(86.7%vs.80.0%)and the hemostatic effective rate(96.7%vs.90.0%)of the patients between groups(P>0.05).The levels of ALD,ACTH,and cortisol stress response factor of the patients in both groups after cesarean section had increased significantly,but which of the patients in group A were significantly higher than those of the patients in group B(P<0.05).The levels of AMH,FSH,LH,and E2 of the patients in group A in 3 months after operation were significantly higher than those of the patients in group B(P<0.05),which of the patients in 6 months after cesarean section had no significant different between the two groups(P>0.05).Conclusion:Uterine artery embolization for treating patients with postpartum hemorrhage because of placenta previa after cesarean section has exact curative effect,and which can reduce the stress response effectively with less influence on their postoperative short-term ovarian reserve function of the patients.
作者
童干益
余小妹
苏春梅
陈穗君
TONG Ganyi;YU Xiaomei;SU Chunmei;CHEN Suijun(The Sixth People's Hospital of Huizhou, Huizhou, Guangdong Province, 516211;Hui Ya Hospital of The First Affiliated Hospital, Sun Yat-Sen University, Huizhou;Huizhou Central People's Hospital)
出处
《中国计划生育学杂志》
2021年第12期2664-2667,共4页
Chinese Journal of Family Planning
基金
惠州市科技计划项目(20200403)。
关键词
子宫动脉栓塞术
前置胎盘
剖宫产
产后出血
应激反应
卵巢储备功能
Uterine artery embolization
Placenta previa
Cesarean section
Postpartum hemorrhage
Stress response
Ovarian reserve function
