本文選題：產后出血 + 介入治療�。� 參考：《吉林大學》2015年碩士論文

【摘要】：婦產科血管性介入治療技術，作為介入放射學的一個分支是治療婦產科出血性疾病，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)療技術的不斷發(fā)展，從以往單一手術方式治療產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，其中介入治療應用在產科出血性疾病尤其是產后出血中越來越多。 目的： 探討產后出血性疾病應用介入治療的相關因素。 方法： 1、回顧性分析2010年1月至2015年1月吉林大學第一、第二臨床醫(yī)院收治的61孕產婦因產后出血行介入治療的病歷資料。病例資料包括孕產婦的年齡、孕育時間、孕育史、其他并發(fā)疾病癥狀等，會包括產婦生產情況，如出血量、分娩方式等。分析各種因素對于孕產婦生產的影響。 2、將數據采用SPSS19.0統計學軟件進行處理，采用t檢驗和2檢驗進行分析。 結果： 調查61例產后出血行介入治療患者中，外院分娩后轉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例患者有人工流產史者，36例有剖宮產史；正常分娩的患者有6例，采用剖宮產術終止妊娠者55例，所有研究對象中，最終均存活，無死亡病例。對所有研究對象產后出血的因素進行分析，發(fā)現胎盤因素占第一位，具體包括胎盤前置、粘連、早剝等。其對導致子宮出血存在明顯意義。 結論： 介入治療是治療產后出血、保留患者子宮、挽救患者生命的有效措施之一。產科出血性疾病包括前置胎盤、產后出血、瘢痕妊娠等，，其均可導致患者大量出血，嚴重危及患者生命。其中產后出血應用介入治療方式取得顯著效果，并隨經濟增長、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婦分娩期間的相關保健工作，較大預防力度，對健康分娩做正確宣傳。近年來，分娩率不斷上升，剖宮產率也隨之增加，無指證剖宮產逐年增加，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婦的生產方式的選擇，增加產后出血的可能性，而其避免措施就是盡量減少子宮操作，如減少剖宮產使用的幾率，從而減少子宮瘢痕的形成，降低孕產婦再次妊娠的危險因素。一經發(fā)現產后出血的患者，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.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R714.461

【參考文獻】

相關期刊論文 前10條

1 初虹;林振文;周霞平;竇永充;;介入化療治療子宮內膜癌術后盆腔復發(fā)的初步臨床探討[J];當代醫(yī)學;2010年05期

2 林浩;舒峰;;子宮肌瘤介入治療12例療效及副反應分析[J];淮海醫(yī)藥;2009年06期

3 蔣榮珍,陳漢平;14例難治性產后出血介入治療臨床療效分析[J];中國計劃生育學雜志;2003年02期

4 朱雪瓊,岳天孚,王德華;術前介入化療在子宮內膜癌的應用及對手術的影響[J];介入放射學雜志;2001年03期

5 張國福;田曉梅;韓志剛;王雪珍;王冬燕;徐叢劍;;介入化療栓塞在宮頸癌術前的臨床應用[J];介入放射學雜志;2009年02期

6 張國福;王添平;谷守欣;韓志剛;張娣;田曉梅;王雪珍;于菲;黃紫蓉;;子宮動脈化療栓塞在剖宮產切口瘢痕妊娠中的應用研究[J];介入放射學雜志;2010年12期

7 陳華,曹野;剖宮產后疤痕處妊娠人流術前行子宮動脈栓塞一例[J];臨床放射學雜志;2005年01期

8 廉曉玲;王海龍;;子宮動脈栓塞術聯合宮腔鏡治療子宮瘢痕妊娠48例臨床分析[J];牡丹江醫(yī)學院學報;2014年03期

9 王輝,張建華,吳味辛;植入性胎盤23例臨床分析[J];實用婦產科雜志;2005年02期

10 劉萍,陳春林;子宮肌瘤血管性介入治療的新進展[J];實用婦產科雜志;2005年04期

本文編號：1943415