本文選題：產(chǎn)后出血 + 介入治療��； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：婦產(chǎn)科血管性介入治療技術(shù)，作為介入放射學(xué)的一個分支是治療婦產(chǎn)科出血性疾病，挽救患者生命、保留生育功能的重要手段及措施。隨著近年來醫(yī)療技術(shù)的不斷發(fā)展，從以往單一手術(shù)方式治療產(chǎn)科潛在出血性疾病的方案，演變?yōu)榻裉炜晒┻x擇的多種治療方式，其中介入治療應(yīng)用在產(chǎn)科出血性疾病尤其是產(chǎn)后出血中越來越多。 目的： 探討產(chǎn)后出血性疾病應(yīng)用介入治療的相關(guān)因素。 方法： 1、回顧性分析2010年1月至2015年1月吉林大學(xué)第一、第二臨床醫(yī)院收治的61孕產(chǎn)婦因產(chǎn)后出血行介入治療的病歷資料。病例資料包括孕產(chǎn)婦的年齡、孕育時間、孕育史、其他并發(fā)疾病癥狀等，會包括產(chǎn)婦生產(chǎn)情況，如出血量、分娩方式等。分析各種因素對于孕產(chǎn)婦生產(chǎn)的影響。 2、將數(shù)據(jù)采用SPSS19.0統(tǒng)計學(xué)軟件進行處理，采用t檢驗和2檢驗進行分析。 結(jié)果： 調(diào)查61例產(chǎn)后出血行介入治療患者中，外院分娩后轉(zhuǎn)入吉大一院與我院進行介入治療19例，于本院分娩后出血行介入治療42例。行介入治療患者中16例前置胎盤合并胎盤植入，12例宮縮乏力，11例前置胎盤，胎盤粘連、植入患者10例，胎盤早剝6例，妊娠合并子 宮肌瘤6例。47例患者有人工流產(chǎn)史者，36例有剖宮產(chǎn)史；正常分娩的患者有6例，采用剖宮產(chǎn)術(shù)終止妊娠者55例，所有研究對象中，最終均存活，無死亡病例。對所有研究對象產(chǎn)后出血的因素進行分析，發(fā)現(xiàn)胎盤因素占第一位，具體包括胎盤前置、粘連、早剝等。其對導(dǎo)致子宮出血存在明顯意義。 結(jié)論： 介入治療是治療產(chǎn)后出血、保留患者子宮、挽救患者生命的有效措施之一。產(chǎn)科出血性疾病包括前置胎盤、產(chǎn)后出血、瘢痕妊娠等，，其均可導(dǎo)致患者大量出血，嚴(yán)重危及患者生命。其中產(chǎn)后出血應(yīng)用介入治療方式取得顯著效果，并隨經(jīng)濟增長、人們文化水平程度提高而使用率呈逐年上升趨勢。切實做好優(yōu)生優(yōu)育、孕婦懷孕期間以及產(chǎn)婦分娩期間的相關(guān)保健工作，較大預(yù)防力度，對健康分娩做正確宣傳。近年來，分娩率不斷上升，剖宮產(chǎn)率也隨之增加，無指證剖宮產(chǎn)逐年增加，以及政府放寬二胎政策，這些政策性因素以及社會因素都會影響到孕產(chǎn)婦的生產(chǎn)方式的選擇，增加產(chǎn)后出血的可能性，而其避免措施就是盡量減少子宮操作，如減少剖宮產(chǎn)使用的幾率，從而減少子宮瘢痕的形成，降低孕產(chǎn)婦再次妊娠的危險因素。一經(jīng)發(fā)現(xiàn)產(chǎn)后出血的患者，及時評估患者，及時制定治療方案，迅速選擇針對患者病情的治療措施，就會大大降低患者發(fā)生難以接受后果的概率。
[Abstract]:As a branch of interventional radiology, vascular interventional therapy in obstetrics and gynecology is an important method and measure to treat gynaecology and obstetrics hemorrhagic diseases, save patients' lives and preserve fertility function. With the continuous development of medical technology in recent years, the single surgical treatment of potentially hemorrhagic obstetric diseases has evolved from a single procedure to a variety of treatments available today. Interventional therapy is used more and more in obstetrical hemorrhagic diseases, especially postpartum hemorrhage. Objective: To explore the related factors of interventional therapy for postpartum hemorrhagic diseases. Methods: 1. The medical records of 61 pregnant women undergoing interventional treatment for postpartum hemorrhage in the first and second Clinical Hospital of Jilin University from January 2010 to January 2015 were analyzed retrospectively. Case data include maternal age, gestation time, gestation history, symptoms of other concurrent diseases, etc., including maternal birth conditions, such as bleeding, delivery methods and so on. The influence of various factors on maternal production was analyzed. 2. The data were processed by SPSS19.0 statistical software, and analyzed by t test and 2 test. Results: Among 61 patients with postpartum hemorrhage undergoing interventional therapy, 19 cases were transferred to Jida first Hospital and our hospital after delivery, and 42 cases were treated with interventional therapy after delivery in our hospital. There were 16 cases of placenta previa with placenta accreta and 12 cases of uterine accretion, 11 cases of placenta previa, placenta adhesion, 10 cases of placenta accreta, 6 cases of placental abruption, and 12 cases of pregnancy complicated with pregnancy. There were 6 cases of uterine leiomyoma with history of induced abortion and 36 cases of cesarean section, and 6 cases of normal delivery and 55 cases of termination of pregnancy by cesarean section. By analyzing the factors of postpartum hemorrhage in all the subjects, we found that placenta was the first factor, including placenta previa, adhesion, abruption and so on. It has obvious significance to cause uterine bleeding. Conclusion: Interventional therapy is one of the effective measures to treat postpartum hemorrhage, preserve uterus and save patient's life. Obstetrical hemorrhagic diseases include placenta previa postpartum hemorrhage scar pregnancy and so on. The effect of interventional therapy on postpartum hemorrhage was significant, and with the economic growth, the educational level of people increased and the utilization rate increased year by year. Do a good job of health care during pregnancy and delivery of pregnant women, do a good job of prevention, and make correct propaganda for healthy delivery. In recent years, the rate of delivery has been rising, the rate of cesarean section has also increased, the number of undocumented caesarean sections has increased year by year, and the government has relaxed its policy on second births. These policy factors and social factors will affect the choice of the mode of production of pregnant women. To increase the possibility of postpartum hemorrhage, the measures to avoid it are to minimize uterine operation, such as reducing the chance of using cesarean section, thus reducing the formation of uterine scar and reducing the risk factors of pregnancy. Once the patient with postpartum hemorrhage is found, the patient is evaluated in time, the treatment plan is made in time, and the treatment measure is chosen quickly, the probability of unacceptable consequences will be greatly reduced.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R714.461

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